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Extrapyramidal reactions with metoclopramide.

D N Bateman, M D Rawlins, J M Simpson

    British Medical Journal (Clinical Research Ed.)
    |October 5, 1985
    PubMed
    Summary
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    Extrapyramidal reactions to metoclopramide, including dystonia-dyskinesia and parkinsonism, were analyzed. Young adults and females aged 12-19 showed higher risks for dystonia-dyskinesia, while the elderly were more prone to parkinsonian reactions.

    Area of Science:

    • Pharmacovigilance
    • Epidemiology
    • Clinical Pharmacology

    Background:

    • Metoclopramide is frequently prescribed for gastrointestinal disorders.
    • Extrapyramidal reactions (EPRs) are known adverse effects of metoclopramide.
    • Understanding the epidemiology of these reactions is crucial for patient safety.

    Purpose of the Study:

    • To investigate the epidemiology of extrapyramidal reactions associated with metoclopramide use.
    • To determine the incidence and risk factors for different types of EPRs.
    • To analyze the relationship between prescribing rates and reported adverse events.

    Main Methods:

    • Utilized data from the UK's Adverse Reactions Register (1967-1982).
    • Compared reported EPRs with general practitioner prescribing figures for metoclopramide.

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  • Calculated relative risks and reporting rates, stratified by age and sex.

    • Main Results:

    • An estimated 15.9 million prescriptions led to 479 EPR reports.
    • Dystonia-dyskinesia was more common in females (relative risk 1.8) and young adults (12-19 years).
    • Parkinsonian reactions were significantly more frequent in the elderly population.

    Conclusions:

    • Metoclopramide-induced EPRs exhibit distinct epidemiological patterns based on reaction type and patient demographics.
    • Young females are at a heightened risk for dystonia-dyskinesia, whereas the elderly are more susceptible to parkinsonian reactions.
    • These findings underscore the importance of age- and sex-specific risk assessments for metoclopramide therapy.