Psychiatric Adverse Effects From Prucalopride in a Medically Complex Adolescent

Background: Prucalopride is a highly selective, 5-HT4 receptor agonist that can be used for the treatment of chronic constipation in individuals for whom laxatives fail to provide adequate relief. The current case study describes adverse neuropsychiatric symptoms following the administration of prucalopride in a 15-year-old female with a complex physical and mental health history to manage chronic constipation. Case Summary: A single 2 mg dose of prucalopride was prescribed to a 15-year-old female to manage her chronic constipation due to a diagnosis of autoimmune enteric neuropathy. Following the oral administration of prucalopride, the patient started experiencing visual and auditory hallucinations, along with suicidal ideation. Prucalopride was ceased, with the patient receiving psychopharmacology and psychological intervention to address the acute onset psychiatric symptoms. Practical Implications: To our knowledge, this is the second documented case of acute onset neuropsychiatric symptoms following the administration of prucalopride. Clinicians should be aware of this possible side effect, particularly if considering administering prucalopride in patients with neurodevelopmental and psychiatric comorbid histories. Increased supervision and monitoring is recommended in these patients if prucalopride is administrated.