E M Hagen1, E Farbu, L Bindoff. 1. Nevrologisk avdeling Haukeland Sykehus 5021 Bergen. ellen.merete.hagen@haukeland.no
Abstract
BACKGROUND: Metoclopramide is an antiemetic drug used frequently both in general practice and hospitals. The drug has few side effects, mainly drowsiness, and can be used both in pregnancy and breastfeeding. Acute dystonia is a rare side effect mostly affecting children and young adults within 1-3 days after start of the medication. Women are more frequently affected than men. MATERIAL AND METHODS: We present a clinical description of two patients admitted to our department with acute dystonia precipitated by metoclopramide. RESULTS: Both patients received treatment with biperiden; one received additional benzodiazepine. Both recovered rapidly and were discharged symptom free the next day. INTERPRETATION: Metoclopramide-induced dystonia is frightening both for the patient and the family. Because of concomitant anxiety and psychiatric symptoms, individuals are often regarded as hysterical. The attack can be abbreviated by parenteral administration of anticholinergic drugs. It is important that all doctors prescribing metoclopramide know of this side effect, especially when their patients are young females.
BACKGROUND:Metoclopramide is an antiemetic drug used frequently both in general practice and hospitals. The drug has few side effects, mainly drowsiness, and can be used both in pregnancy and breastfeeding. Acute dystonia is a rare side effect mostly affecting children and young adults within 1-3 days after start of the medication. Women are more frequently affected than men. MATERIAL AND METHODS: We present a clinical description of two patients admitted to our department with acute dystonia precipitated by metoclopramide. RESULTS: Both patients received treatment with biperiden; one received additional benzodiazepine. Both recovered rapidly and were discharged symptom free the next day. INTERPRETATION:Metoclopramide-induced dystonia is frightening both for the patient and the family. Because of concomitant anxiety and psychiatric symptoms, individuals are often regarded as hysterical. The attack can be abbreviated by parenteral administration of anticholinergic drugs. It is important that all doctors prescribing metoclopramide know of this side effect, especially when their patients are young females.