TY - JOUR
T1 - Drug Insight
T2 - From disturbed motility to disordered movement - A review of the clinical benefits and medicolegal risks of metoclopramide
AU - Pasricha, P. Jay
AU - Pehlivanov, Nonko
AU - Sugumar, Aravind
AU - Jankovic, Joseph
PY - 2006/3
Y1 - 2006/3
N2 - Metoclopramide, the only drug approved by the FDA for treatment of diabetic gastroparesis, but used off-label for a variety of other gastrointestinal indications, has many potentially troublesome adverse neurologic effects, particularly movement disorders. In this article, we comprehensively review the indications and side effects of metoclopramide, and describe some common pitfalls and strategies to minimize the medicolegal risks to the prescribing physician. Metoclopramide accounts for nearly a third of all drug-induced movement disorders, a common reason for a malpractice suit. The entire spectrum of drug-induced movement disorders, ranging from subtle to life-threatening, can ensue from its use; akathisia and dystonia are generally seen early in the course of metoclopramide-induced movement disorders, whereas tardive dyskinesia and parkinsonism seem to be more prevalent in chronic users. Female sex, age and diabetes are the major risk factors for metoclopramide-induced movement disorders. It is therefore incumbent on gastroenterologists and other prescribing physicians to become familiar with the adverse neurologic effects associated with the use of metoclopramide, and to take appropriate preventive and defensive measures.
AB - Metoclopramide, the only drug approved by the FDA for treatment of diabetic gastroparesis, but used off-label for a variety of other gastrointestinal indications, has many potentially troublesome adverse neurologic effects, particularly movement disorders. In this article, we comprehensively review the indications and side effects of metoclopramide, and describe some common pitfalls and strategies to minimize the medicolegal risks to the prescribing physician. Metoclopramide accounts for nearly a third of all drug-induced movement disorders, a common reason for a malpractice suit. The entire spectrum of drug-induced movement disorders, ranging from subtle to life-threatening, can ensue from its use; akathisia and dystonia are generally seen early in the course of metoclopramide-induced movement disorders, whereas tardive dyskinesia and parkinsonism seem to be more prevalent in chronic users. Female sex, age and diabetes are the major risk factors for metoclopramide-induced movement disorders. It is therefore incumbent on gastroenterologists and other prescribing physicians to become familiar with the adverse neurologic effects associated with the use of metoclopramide, and to take appropriate preventive and defensive measures.
KW - Indications
KW - Medicolegal risk
KW - Metoclopramide
KW - Movement disorder
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U2 - 10.1038/ncpgasthep0442
DO - 10.1038/ncpgasthep0442
M3 - Review article
C2 - 16511548
AN - SCOPUS:33645293206
SN - 1743-4378
VL - 3
SP - 138
EP - 148
JO - Nature Clinical Practice Gastroenterology and Hepatology
JF - Nature Clinical Practice Gastroenterology and Hepatology
IS - 3
ER -