Extrapyramidal side effects of antiemetics presenting as psychiatric illness.
Although extrapyramidal side effects of two commonly used antiemetics, metoclopramide and prochlorperazine, are well known, it may be difficult for even the experienced practitioner to distinguish some of these extrapyramidal reactions from such psychiatric symptoms as anxiety, depression, or catatonia. Certain patient groups have increased susceptibility to these extrapyramidal reactions, including patients under 30, those with AIDS, those with renal disease, oncology patients, and possibly women. Physicians should maintain a high index of suspicion for depression, anxiety, or catatonia if their patients are taking antiemetics. These symptoms may be extrapyramidal side effects of the antiemetic rather than indications of a primary mental disorder.
Rodgers
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Division of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, Pennsylvania.
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D000368:Aged; D017109:Akathisia, Drug-Induced; D000932:Antiemetics / Q000009:adverse effects* / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000139:chemically induced / Q000175:diagnosis / Q000523:psychology; D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects* / Q000627:therapeutic use; D009460:Neurologic Examination; D010302:Parkinson Disease, Secondary / Q000139:chemically induced / Q000175:diagnosis / Q000523:psychology; D011346:Prochlorperazine / Q000009:adverse effects* / Q000627:therapeutic use; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000523:psychology
D000932:Antiemetics; D008787:Metoclopramide; D011346:Prochlorperazine