Idiopathic Intracranial Hypertension After Abrupt Cessation of Medication: A Case Report of Abrupt Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Cessation and Review of the Literature

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY Current Pain and Headache Reports Pub Date : 2024-04-04 DOI:10.1007/s11916-024-01215-9

Brittany Heckel

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Abstract

Purpose of Review

The purpose of this review is two-fold: (1) to discuss a case report of idiopathic intracranial hypertension (IIH) after abrupt cessation of a glucagon-like peptide-1 (GLP-1) receptor agonist with resultant rapid weight gain and (2) to review the literature regarding the potential role of GLP-1 receptor agonists in the treatment of IIH as well as potential pitfalls.

Recent Findings

GLP-1 receptor agonists have become widely used to treat obesity. Obesity is a known risk factor for the development of IIH, though the precise pathophysiology is unclear. GLP-1 receptor agonists may help treat IIH by promoting weight loss, lipolysis of adipose tissue, and potentially decreasing the secretion of CSF, as was seen in rat models. Abrupt cessation of GLP-1 receptor agonists can result in regaining lost weight rapidly. In the case that we present, the patient stopped duraglutide abruptly due to lack of insurance coverage and regained the weight she had lost within a month. She subsequently developed IIH.

Summary

GLP-1 receptor agonists have the potential to help treat IIH; however, this class of medication needs to be used carefully, as cessation of the medication and resultant rapid weight gain can result in IIH.

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突然停药后的特发性颅内高压：胰高血糖素样肽-1（GLP-1）受体激动剂突然停药的病例报告和文献综述

综述目的本综述有两个目的：(1) 讨论一例在突然停用胰高血糖素样肽-1 (GLP-1) 受体激动剂后导致体重迅速增加的特发性颅内高压 (IIH) 病例报告；(2) 综述有关 GLP-1 受体激动剂在 IIH 治疗中的潜在作用以及潜在隐患的文献。虽然确切的病理生理学尚不清楚，但肥胖是IIH发病的一个已知风险因素。GLP-1 受体激动剂可促进体重减轻、脂肪组织脂肪分解，并有可能减少 CSF 的分泌，从而有助于治疗 IIH，这一点在大鼠模型中也有所体现。突然停用 GLP-1 受体激动剂会导致失去的体重迅速恢复。在我们介绍的病例中，患者由于没有保险而突然停用度拉鲁肽，结果在一个月内体重又恢复了。小结GLP-1受体激动剂有可能有助于治疗IIH；但是，这类药物需要谨慎使用，因为停药后体重迅速增加可能导致IIH。

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来源期刊

Current Pain and Headache Reports CLINICAL NEUROLOGY-

CiteScore

6.10

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings regarding the diagnosis, treatment, and management of pain and headache. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of pain and headache. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as anesthetic techniques in pain management, cluster headache, neuropathic pain, and migraine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.