[Severe parkinsonism due to metoclopramide in a patient with polypharmacy].
A 73-year-old woman, with tuberculosis of the large intestine, developed nausea as a side effect of the antituberculosis drugs. The nausea was treated with metoclopramide. Subsequently she developed severe medication-induced parkinsonism. As her symptoms initially mimicked a depressive disorder, drug-induced parkinsonism was only considered at a later stage. Due to drug-induced impaired function of the liver and kidney the patient had received a toxic dose of metoclopramide. Treatment with biperiden and withdrawal of the metoclopramide resulted in a reduction of the complaints within 3 months, after which the anti-tuberculosis medication could be reintroduced. Adjusting the dose of metoclopramide could possibly have prevented this severe side effect.
Hoogendam
A
A
Afd. Klinische Geriatrie, Universitair Medisch Centrum, Utrecht. hoogendam-dekkers@zonnet.nl
Hofmeijer
J
J
Frijns
C J M
CJ
Heeringa
M
M
Schouten-Tjin a Tsoi
S L N M
SL
Jansen
P A F
PA
D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000009:adverse effects; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008787:Metoclopramide / Q000008:administration & dosage / Q000009:adverse effects*; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy; D010302:Parkinson Disease, Secondary / Q000139:chemically induced*; D019338:Polypharmacy; D012074:Remission Induction; D014385:Tuberculosis, Gastrointestinal / Q000188:drug therapy
D000932:Antiemetics; D000995:Antitubercular Agents; D018492:Dopamine Antagonists; D008787:Metoclopramide