title: Domperidone-induced tardive dyskinesia and withdrawal psychosis in an elderly woman with dementia.
abstract: OBJECTIVE
  To report a case of probable domperidone-induced tardive dyskinesia and withdrawal psychosis in an elderly woman.
  
  
  METHODS
  A 75-year-old woman was first assessed for cognitive decline and personality changes. On clinical examination, diffuse choreoathetoid movements were noted. Chronic domperidone use seemed the most likely cause for the movement disorder and was abruptly discontinued. Within a few days, she developed a severe psychotic syndrome with Capgras delusions; the movement disorder continued unabated. Both the movement disorder and psychotic symptoms promptly remitted with risperidone treatment.
  
  
  CONCLUSIONS
  Domperidone has, on rare occasions, been associated with acute extrapyramidal syndromes, especially in young children, but, to our knowledge, this is the first case of domperidone-induced tardive dyskinesia and withdrawal psychosis, adverse effects associated with chronic central nervous system dopaminergic blockade. Domperidone is a dopamine D₂ receptor antagonist that does not usually cross the blood-brain barrier. However, blood-brain barrier alterations occur with aging and dementia, which may explain central nervous system penetration of domperidone in our patient, diagnosed with probable frontotemporal dementia. The association was rated as probable on the Naranjo probability scale.
  
  
  CONCLUSIONS
  Chronic use of domperidone may, on rare occasions, induce neuropsychiatric syndromes similar to those seen with the use of antipsychotics. This may be more likely in situations in which the blood-brain barrier is damaged, as in vascular and degenerative dementias.
authors.affiliation: Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Jean-Francois.Trudel@USherbrooke.ca
authors.forename: Jessika
authors.initials: J
authors.lastname: Roy-Desruisseaux
authors.forename: Julie
authors.initials: J
authors.lastname: Landry
authors.forename: Christian
authors.initials: C
authors.lastname: Bocti
authors.forename: Daniel
authors.initials: D
authors.lastname: Tessier
authors.forename: Paule
authors.initials: P
authors.lastname: Hottin
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Trudel
mesh_terms: D000368:Aged; D001812:Blood-Brain Barrier / Q000378:metabolism / Q000473:pathology; D003704:Dementia / Q000188:drug therapy; D004294:Domperidone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D065127:Dopamine D2 Receptor Antagonists; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D005260:Female; D006801:Humans; D011618:Psychotic Disorders / Q000209:etiology*; D018967:Risperidone / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology
chemical_list: D018492:Dopamine Antagonists; D065127:Dopamine D2 Receptor Antagonists; D004294:Domperidone; D018967:Risperidone