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Myoclonus Induced by Metoclopramide Therapy

Myoclonus Induced by Metoclopramide Therapy Abstract • Metoclopramide hydrochloride is increasingly used as an antiemetic agent. Clinical and experimental studies have demonstrated dopamine antagonism, and extrapyramidal side effects have been reported in patients given the drug for gastrointestinal disorders. Multifocal myoclonic jerking developed in our patient after he received metoclopramide therapy for gastroparesis due to renal failure. He had had no previous neurologic symptoms, and no evidence of CNS abnormality was found; the myoclonic jerking subsided when metoclopramide therapy was discontinued. Multifocal myoclonus must be differentiated from seizure activity in patients with renal failure and other metabolic encephalopathies. Metoclopramide clearance is reduced in renal failure, and myoclonus or other neurologic complications may be precipitated in such patients by usual doses of this drug. (Arch Intern Med 1983;143:2201-2202) References 1. Ahte EL, Buncum BEG: Metoclopramide induces catalepsy and increases striatal homovanillic acid content in mice. Acta Pharmacol Toxicol 1974;35:429-432.Crossref 2. Schulze-Delrieu K: Metoclopramide. N Engl J Med 1981;305:28-33.Crossref 3. Pinder RM, Brogden RN, Sawyer TR, et al: Metoclopramide: A review of its pharmacological properties and clinical use. Drugs 1976;12:81-131.Crossref 4. Lavy S, Melamed E, Penchas S: Tardive dyskinesia associated with metoclopramide. Br Med J 1978;1:77-78.Crossref 5. Robinson OPW: Metoclopramide: Its side effects and safety. Postgrad Med J 1973;49( (suppl 4) ):77-80.Crossref 6. Indo T, Ando K: Metoclopramide-induced parkinsonism: Clinical characteristics in ten cases. Arch Neurol 1982;39:494-496.Crossref 7. Raskin NH, Fishman RA: Neurologic disorders in renal failure. N Engl J Med 1976;294:143-148.Crossref 8. Tarsy D, Parkes JD, Marsden CD: Metoclopramide and pimozide in Parkinson's disease and levodopa-induced dyskinesias. J Neurol Neurosurg Psychiatry 1975;38:331-335.Crossref 9. Bateman DN, Gokal R: Metoclopramide in renal failure. Lancet 1980;1:982.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Myoclonus Induced by Metoclopramide Therapy

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350110191040
Publisher site
See Article on Publisher Site

Abstract

Abstract • Metoclopramide hydrochloride is increasingly used as an antiemetic agent. Clinical and experimental studies have demonstrated dopamine antagonism, and extrapyramidal side effects have been reported in patients given the drug for gastrointestinal disorders. Multifocal myoclonic jerking developed in our patient after he received metoclopramide therapy for gastroparesis due to renal failure. He had had no previous neurologic symptoms, and no evidence of CNS abnormality was found; the myoclonic jerking subsided when metoclopramide therapy was discontinued. Multifocal myoclonus must be differentiated from seizure activity in patients with renal failure and other metabolic encephalopathies. Metoclopramide clearance is reduced in renal failure, and myoclonus or other neurologic complications may be precipitated in such patients by usual doses of this drug. (Arch Intern Med 1983;143:2201-2202) References 1. Ahte EL, Buncum BEG: Metoclopramide induces catalepsy and increases striatal homovanillic acid content in mice. Acta Pharmacol Toxicol 1974;35:429-432.Crossref 2. Schulze-Delrieu K: Metoclopramide. N Engl J Med 1981;305:28-33.Crossref 3. Pinder RM, Brogden RN, Sawyer TR, et al: Metoclopramide: A review of its pharmacological properties and clinical use. Drugs 1976;12:81-131.Crossref 4. Lavy S, Melamed E, Penchas S: Tardive dyskinesia associated with metoclopramide. Br Med J 1978;1:77-78.Crossref 5. Robinson OPW: Metoclopramide: Its side effects and safety. Postgrad Med J 1973;49( (suppl 4) ):77-80.Crossref 6. Indo T, Ando K: Metoclopramide-induced parkinsonism: Clinical characteristics in ten cases. Arch Neurol 1982;39:494-496.Crossref 7. Raskin NH, Fishman RA: Neurologic disorders in renal failure. N Engl J Med 1976;294:143-148.Crossref 8. Tarsy D, Parkes JD, Marsden CD: Metoclopramide and pimozide in Parkinson's disease and levodopa-induced dyskinesias. J Neurol Neurosurg Psychiatry 1975;38:331-335.Crossref 9. Bateman DN, Gokal R: Metoclopramide in renal failure. Lancet 1980;1:982.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1983

References