The Prevalence of Metoclopramide-Induced Tardive Dyskinesia and Acute Extrapyramidal Movement Disorders

Linda Ganzini, Daniel Casey, William F. Hoffman, Anthony L. Mccall

Research output: Contribution to journalArticle

185 Citations (Scopus)

Abstract

Background: Metoclopramide hydrochloride, a neuroleptic dopamine receptor antagonist used to treat gastric ailments, is reported to cause extrapyramidal movement disorders. The goals of this study were (1) to determine the prevalence and severity of tardive dyskinesia and acute extrapyramidal movement syndromes including akathisia, acute dystonia, and drug-induced parkinsonism in metoclopramide-treated patients and (2) to compare the prevalence and severity of tardive dyskinesia in metoclopramide-treated diabetics and nondiabetics. Methods: From a list of metoclopramide-treated patients received from the Portland (Ore) Veterans Affairs Medical Center pharmacy, 53 patients met inclusion criteria and 51 (96%) agreed to participate. Controls consisted of a convenience sample drawn from the Portland Veterans Affairs Medical Center Outpatient Clinic who were matched to subjects on age (±10 years), gender, and presence or absence of diabetes. Of 61 potential controls contacted, 51 (84%) agreed to participate. Metoclopramide-treated subjects and controls were seen by a rater who was "blind" to all diagnoses and treatments. The rater performed a standardized examination used to elicit signs and symptoms of tardive dyskinesia and acute extrapyramidal movement syndromes. Results: The relative risk for tardive dyskinesia was 1.67 (95% confidence interval, 0.93 to 2.97), and the relative risk for drug-induced parkinsonism was 4.0 (95% confidence interval, 1.5 to 10.5). Metoclopramide-treated patients had significantly greater severity of tardive dyskinesia, drug-induced parkinsonism, and subjective akathisia than controls. Use of metoclopramide was associated with impairment in ambulation and increased use of benzodiazepines. Conclusions: Metoclopramidetreated diabetics had significantly greater severity of tardive dyskinesia than metoclopramide-treated nondiabetics. Metoclopramide use is associated with a significantly increased prevalence and severity of several extrapyramidal movement disorders.

Original languageEnglish (US)
Pages (from-to)1469-1475
Number of pages7
JournalArchives of Internal Medicine
Volume153
Issue number12
DOIs
StatePublished - Jun 28 1993

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Basal Ganglia Diseases
Metoclopramide
Movement Disorders
Parkinsonian Disorders
Psychomotor Agitation
Veterans
Pharmaceutical Preparations
Confidence Intervals
Tardive Dyskinesia
Dopamine Antagonists
Dystonia
Ambulatory Care Facilities
Benzodiazepines
Signs and Symptoms
Walking
Stomach

ASJC Scopus subject areas

  • Internal Medicine

Cite this

The Prevalence of Metoclopramide-Induced Tardive Dyskinesia and Acute Extrapyramidal Movement Disorders. / Ganzini, Linda; Casey, Daniel; Hoffman, William F.; Mccall, Anthony L.

In: Archives of Internal Medicine, Vol. 153, No. 12, 28.06.1993, p. 1469-1475.

Research output: Contribution to journalArticle

Ganzini, Linda ; Casey, Daniel ; Hoffman, William F. ; Mccall, Anthony L. / The Prevalence of Metoclopramide-Induced Tardive Dyskinesia and Acute Extrapyramidal Movement Disorders. In: Archives of Internal Medicine. 1993 ; Vol. 153, No. 12. pp. 1469-1475.
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abstract = "Background: Metoclopramide hydrochloride, a neuroleptic dopamine receptor antagonist used to treat gastric ailments, is reported to cause extrapyramidal movement disorders. The goals of this study were (1) to determine the prevalence and severity of tardive dyskinesia and acute extrapyramidal movement syndromes including akathisia, acute dystonia, and drug-induced parkinsonism in metoclopramide-treated patients and (2) to compare the prevalence and severity of tardive dyskinesia in metoclopramide-treated diabetics and nondiabetics. Methods: From a list of metoclopramide-treated patients received from the Portland (Ore) Veterans Affairs Medical Center pharmacy, 53 patients met inclusion criteria and 51 (96{\%}) agreed to participate. Controls consisted of a convenience sample drawn from the Portland Veterans Affairs Medical Center Outpatient Clinic who were matched to subjects on age (±10 years), gender, and presence or absence of diabetes. Of 61 potential controls contacted, 51 (84{\%}) agreed to participate. Metoclopramide-treated subjects and controls were seen by a rater who was {"}blind{"} to all diagnoses and treatments. The rater performed a standardized examination used to elicit signs and symptoms of tardive dyskinesia and acute extrapyramidal movement syndromes. Results: The relative risk for tardive dyskinesia was 1.67 (95{\%} confidence interval, 0.93 to 2.97), and the relative risk for drug-induced parkinsonism was 4.0 (95{\%} confidence interval, 1.5 to 10.5). Metoclopramide-treated patients had significantly greater severity of tardive dyskinesia, drug-induced parkinsonism, and subjective akathisia than controls. Use of metoclopramide was associated with impairment in ambulation and increased use of benzodiazepines. Conclusions: Metoclopramidetreated diabetics had significantly greater severity of tardive dyskinesia than metoclopramide-treated nondiabetics. Metoclopramide use is associated with a significantly increased prevalence and severity of several extrapyramidal movement disorders.",
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