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Metoclopramide-induced impotence and akathisia: a case report
1Department of Psychiatry, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Abstract:
Metoclopramide (Primperan), a benzamide antiemetic drug, is frequently used in gastrointestinal disorders. Because of its central dopamine antagonist property, it can be a potent stimulant of prolactin release and cause extrapyramidal movement disorders. The case presented is an aged male who developed impotence and akathisia after long-term use of metoclopramide. Akathisia disappeared within 24 hours after withdrawal of metoclopramide. One month after cessation of this drug, his sexual function returned to normal and, in the subsequent five months, he continued to have normal erection. Prolactin level mildly elevated during metoclopramide treatment. It decreased a little two weeks after stopping metoclopramide but elevated again two months later. The characters of these adverse effects of metoclopramide and the prolactin levels of long-term metoclopramide treatment will be discussed. Since metoclopramide is widely used in patients with gastric problems and in cancer patients as antiemetic. It is suggested that long-term use of metoclopramide should be avoided and patients should be carefully observed for potential adverse effects.
Insights
Long-term metoclopramide use can cause impotence and akathisia due to its dopamine-blocking effects. These adverse effects may resolve after discontinuing the antiemetic drug, metoclopramide (Primperan).
Area of Science:
- Pharmacology
- Neurology
- Gastroenterology
Background:
- Metoclopramide (Primperan) is a benzamide antiemetic widely prescribed for gastrointestinal disorders.
- Its central dopamine antagonist properties can lead to elevated prolactin and extrapyramidal side effects.
- Long-term use necessitates careful consideration of potential adverse events.