Metoclopramide in Parkinson’s Disease: A Common Drug with a Hidden Risk

General
1

Metoclopramide
An antiemetic that works by blocking dopamine receptors in the brain and gut.

The Dopamine conflict:
Parkinson’s disease is caused by the progressive loss of dopamine- producing neurons in the brain. Metoclopramide, however works by blocking dopamine receptors in the brain which counteract the effect of PD medication and worsens the disease motor symptoms.

Extrapyramidal side effects :

  1. Acute dystonic reactions.
    Involuntary muscle contractions causing twisting and repetitive movements of body
  2. Parkinsonism.
    Mimicking PD symptoms like tremors.
  3. Akathisia.
    Inability to stay still.
  4. Tardive dyskinesia:
    Repetitive body movements that can become irreversible with long term use.
    Mimicking PD symptoms like tremors.

Q; What strategies can reduce the risk of prescribing contraindicated medications to Parkinson’s patients?

MBH/DB

1 Like
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Great point. Regular medication reconciliation, clinical decision-support systems, and increased awareness of dopamine-blocking medications among healthcare professionals can help reduce the risk of prescribing contraindicated drugs to patients with Parkinson’s disease.

3

Prescribers must avoid dopamine blocking agents and MAO-B inhibitors.