Posted by ed_uk on November 30, 2004, at 10:50:54
In reply to Re: drug-induced illness » lostforwards, posted by Larry Hoover on November 30, 2004, at 10:10:32
Hello...
After my own dire experience with AP-induced akathisia and dystonia I will be forever 'in awe' of the toxicity of APs.
Although it is clear that dyskinesia may occur in the absence of neuroleptics, it is important not to forget that TD can occur in non-psychotic patients prescribed dopamine antagonists. I have no doubt in my mind that APs can cause TD.
The use of anti-emetic dopamine antagonists to treat non-psychiatric problems provides an example of what I am saying. Metoclopramide for example......
Metoclopramide-induced tardive dyskinesia in an infant.
Mejia NI, Jankovic J.
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
We describe a 1-year-old girl who developed orofaciolingual stereotypy at age 2 months after a 17-day treatment with metoclopramide for gastroesophageal reflux. The stereotypy, documented by sequential videos, persisted for at least 9 months after the drug was discontinued. This patient represents the first documented case of tardive dyskinesia in an infant. We also review previous reports of tardive dyskinesia in children.
J Pediatr. 1992 Dec;121(6):983-5. Related Articles, Links
Tardive dyskinesia associated with use of metoclopramide in a child.Putnam PE, Orenstein SR, Wessel HB, Stowe RM.
Department of Pediatrics, Children's Hospital of Pittsburgh, PA 15213.
Tardive dyskinesia is a chronic, often permanent, movement disorder that has been reported in elderly patients receiving metoclopramide. We describe an 8-year-old boy with tardive dyskinesia that developed when he received metoclopramide as part of therapy for gastroesophageal reflux and erosive esophagitis.
Metoclopramide-associated tardive dyskinesia in hemodialysis patients with diabetes mellitus. Two case reports.Sewell DD, Yoshinobu BH, Caligiuri MP, Jeste DV.
University of California, San Diego.
Metoclopramide, a drug used almost exclusively for medical indications, is a dopamine (D-2) receptor blocker and has been reported to cause extrapyramidal side effects. We present two case reports of hemodialysis patients who were treated with metoclopramide for diabetic gastroparesis. Within 12 months of beginning treatment, both patients developed persistent tardive dyskinesia. These cases highlight the fact that some patients who benefit from metoclopramide may also have a relatively high risk of developing persistent tardive dyskinesia. The consultation-liaison psychiatrist can play an important role in the education of the medical staff regarding metoclopramide-induced tardive dyskinesia.
Arch Fam Med. 1992 Nov;1(2):271-8. Related Articles, Links
Metoclopramide-associated tardive dyskinesia. An analysis of 67 cases.Sewell DD, Jeste DV.
Department of Psychiatry, University of California, San Diego.
OBJECTIVE: To summarize information regarding the frequency, risk factors, clinical characteristics, treatment, and course of metoclopramide hydrochloride-associated tardive dyskinesia obtained from an analysis of 67 case reports. DATA SOURCES: All the case reports of metoclopramide-associated tardive dyskinesia involving human patients in the literature in English obtained by using Index Medicus and Med-Search. The indexing terms used were as follows: metoclopramide, tardive dyskinesia, dyskinesia, parkinsonism, and extrapyramidal side effects. STUDY SELECTION: For a patient to be included, the main published research criteria had to be met based on the information provided. These criteria included exposure to metoclopramide for at least 30 days before the onset of dyskinesia. Fifty-two patients met these criteria. DATA EXTRACTION: One author independently extracted the data. DATA SYNTHESIS: The incidence and prevalence of tardive dyskinesia associated with metoclopramide have not been well studied. The mean (+/- SD) length of treatment with metoclopramide before the onset of symptoms was 20 +/- 15 months. The most common location of the dyskinetic movements was the face (28 [60%] of 47) followed by the tongue (21 [45%] of 47). In 15 (71%) of 21 patients on whom long-term follow-up was provided, the symptoms were still present 6 months or more after discontinuation of metoclopramide. CONCLUSION: Persistent tardive dyskinesia is a serious potential side effect associated with metoclopramide treatment.
Ed.
poster:ed_uk
thread:422246
URL: http://www.dr-bob.org/babble/20041128/msgs/422333.html