METOCLOPRAMIDE – INDUCED EXTRAPYRAMIDAL SIGNS AND SYMPTOMS – BRIEF REVIEW OF LITERATURE AND CASE REPORT.

Abstract

Introduction: Metoclopramide is a dopamine receptor agonist and well known antiemetic and gastrokynetic agent. Its usage has been restricted by European Medicines Agency (EMA), because of acute and chronic neurological adverse events. Extrapyramidal syndromes, including parkinsonism, tardive dyskinesia, akathisia and acute dystonias, are the most reported and most often drug side effects. Contingent and methods: We present a case of 23 years old woman with a 3-year history of Metoclopramide-induced recurrent oculogyric crises. Results: The patient suffered from examinophobia, with minimal benzodiazepine symptoms relief. She willfully took small dosages of oral Metoclopramide for nausea relief before her examinations, which lead to recurrent oculogyric crises, short after the drug intake. After a detailed explanation of drug side effects and medicine discontinuation, they disappeared. She had no significant medical and family history of neurological and psychiatric conditions. Laboratory data were normal. Conclusions: Metoclopramide could induce acute or chronic neurological conditions and its usage should be restricted in general population to some specific conditions. Some of its adverse reactions are often misdiagnosed and improperly treated. Critical drug anamnesis with a focus on Metoclopramide usage in some cases could enhance diagnosis.

Keywords

• Metoclopramide side effects
• dopamine antagonist
• oculogyric crises