Metoclopramide-induced parkinsonism in hemodialysis patients. Report of two cases
Sirota, R.A.; Kimmel, P.L.; Trichtinger, M.D.; Diamond, B.F.; Stein, H.D.; Yudis, M.
Archives of Internal Medicine 146(10): 2070-2071
1986
ISSN/ISBN: 0003-9926 PMID: 3767555 Document Number: 267780
Metoclopramide hydrochloride is an antiemetic and gastric motility stimulant with a wide variety of extrapyramidal side effects, including parkinsonism. We describe two patients with end-stage renal disease secondary to diabetes mellitus treated with hemodialysis who developed extrapyramidal symptoms during treatment with metoclopramide. One patient with preexisting, well-controlled Parkinson's disease developed increasing rigidity and bradykinesia that became completely refractory to treatment with L-dopa and bromocriptine while taking metoclopramide for diabetic gastroparesis. A second patient with no history of Parkinson's disease developed a resting tremor and facial dyskinesia during treatment with metoclopramide. In both cases, discontinuation of metoclopramide therapy led to prompt improvement of symptoms.