title: Acute dystonic reaction to metoclopramide in patients carrying homozygous cytochrome P450 2D6 genetic polymorphisms.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands. annemiekevanderpadt@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: van der Padt
authors.forename: R H N
authors.initials: RH
authors.lastname: van Schaik
authors.forename: P
authors.initials: P
authors.lastname: Sonneveld
mesh_terms: 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
chemical_list: D018492:Dopamine Antagonists; D019389:Cytochrome P-450 CYP2D6; D008787:Metoclopramide