Case Report

Metoclopramide-Induced Encephalopathy in Parkinson Disease

Authors: Bradley J. Robottom, MD, Lisa M. Shulman, MD, Karen E. Anderson, MD, William J. Weiner, MD

Abstract

A case of prolonged encephalopathy and worsened parkinsonism in a Parkinson disease patient exposed to a short course of metoclopramide is described. Parkinson disease (PD) is the second most common neurodegenerative disease in the United States. Because of the increased susceptibility to adverse drug effects, PD presents a special challenge to physicians. Anti-emetic drugs such as metoclopramide are widely used and may be particularly deleterious to PD patients due to blockade of dopamine receptors.


Key Points


* The clinical spectrum of metoclopramide's adverse effects is broad, and the range of neuropsychiatric adverse effects is underappreciated.


* Patients with Parkinson disease are particularly vulnerable to adverse effects of dopamine receptor blockers.


* Increased knowledge of metoclopramide's adverse effects should lead to safer prescribing practices.

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