Acute dystonic reaction to metoclopramide in patients carrying homozygous cytochrome P450 2D6 genetic polymorphisms.
BACKGROUND
Extrapyramidal syndromes (EPS) are clinically relevant side effects of metoclopramide which are often not anticipated.


METHODS
Two patients who received metoclopramide developed an acute dystonic reaction. Symptoms disappeared after biperiden or trihexyphenidyl were given. Molecular analysis of the CYP2D6 gene was performed using a PCR-based method.


RESULTS
Both patients were homozygous for inactive CYP2D6 alleles (CYP2D6*4/*4 and CYP2D6*4/*5), which are associated with slow drug metabolism.


CONCLUSIONS
Metoclopramide-induced acute dystonic reactions may occur in patients carrying a CYP2D6 genetic polymorphism.
van der Padt
A
A
Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands. annemiekevanderpadt@yahoo.com
van Schaik
R H N
RH
Sonneveld
P
P
D000208:Acute Disease; D000328:Adult; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics* / Q000378:metabolism; D018492:Dopamine Antagonists / Q000009:adverse effects*; D004421:Dystonia / Q000139:chemically induced* / Q000235:genetics; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects*; D011110:Polymorphism, Genetic; D013577:Syndrome
D018492:Dopamine Antagonists; D019389:Cytochrome P-450 CYP2D6; D008787:Metoclopramide