Propoxyphene (Darvon®) Addiction and Withdrawal Syndrome

Abstract

A 31-year-old woman with longstanding psychiatric difficulty was introduced to propoxyphene (Darvon®) by prescription after gynecologic surgery. She gradually developed a primary addiction and took an oral dose that at times reached 2,300 mg daily. She was hospitalized for drug withdrawal and initially maintained on 1,300 mg propoxyphene daily. Laboratory evaluation showed no evidence of chronic liver, kidney, or hematologic toxicity. Placebos were then substituted for the propoxyphene, and definite abstinence symptoms and signs occurred. These consisted of anorexia, rhinitis, and fatigue, followed by irritability and insomnia. Vomiting developed by the end of 48 hr of abstinence. Propoxyphene was then reinstituted, and within 24 hr the patient was asymptomatic. We conclude that tolerance and physical dependence to propoxyphene can occur.