Adverse neurologic effects of metoclopramide

ArticleinCanadian Medical Association journal 126(1):23-5 · February 1982with42 Reads
Source: PubMed
Abstract
Metoclopramide hydrochloride is now commonly prescribed for a variety of gastrointestinal disorders. Over a 2-year period 18 patients with neurologic disorders induced by metoclopramide were assessed at the Parkinson's disease clinic of the Ottawa Civic Hospital. During metoclopramide therapy acute transient dystonic reactions were seen in 4 patients, and parkinsonism, which was frequently misdiagnosed and treated as classic Parkinson's disease, was seen in 12 patients. After treatment with metoclopramide was stopped, tardive dyskinesia appeared in seven patients and has persisted for up to 15 months in three patients. Parkinsonism and tardive dyskinesia occurred in older patients undergoing long-term therapy with metoclopramide. This experience, therefore, suggests that such treatment, especially in older patients, should be avoided.

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  • ... Acute dystonic reactions are also reported following metoclopramide overdose or accidental injection (Sills and Glass, 1978; Kerr, 1996). Metoclopramide doses need to be reduced in patients with renal failure (Bateman and Gokal, 1980; Grimes et al., 1982b). A familial tendency towards metoclopramide-induced dystonia is described (Gatrad and Gatrad, 1979; Miller and Jankovic, 1989; Guala et al., 1992 ). Poorly functioning or nonfunctioning CYP2D6 alleles, which slow metoclopramide metabolism, are reported in some familial cases of metoclopramide-induced dystonia (Van der Padt et al., 2006 ). ...
  • ... The risk of extrapyramidal effects is increased in young adults and children, particularly those with high-dose or prolonged therapy. Metoclopramide blocks central dopaminergic receptors and can induce biochemical and behavioral changes as neuroleptics [23]. This drug is metabolized at least in part by the cytochrome P450 system [24]. ...
  • ... In Spain, several studies have reported that drug-induced parkinsonism accounts for 24 to 35% of parkinsonian syndromesp,5,7,8) The prevalence of drug-induced parkinsonism in a door-to-door survey conducted in Italy was 32.7 per 100 000 individuals, in other words, approximately 8 times less than that of idiopathic Parkinson's disease.[9) Another door-to-door survey conducted in Germany , but restricted to individuals older than 65 years, showed a prevalence of 0.41 % for druginduced parkinsonism and 0.71 % for Parkinson's disease.! 10)[38] Orthopramides and substituted benzamides: metoclopramide39404142434445464748 sulpiride,[ ...
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