| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 339111 | Psychosomatics | 2011 | 7 Pages |
BackgroundMetoclopramide is an anti-emetic and gastrointestinal pro-motility agent associated with well-known neuropsychiatric adverse effects, such as dyskinesia, akathisia, and depression. It has never been reported to be associated with homicidal ideation.ObjectiveThe authors review the literature on metoclopramide-induced adverse neuropsychiatric reactions and the mechanisms by which these may occur.MethodsThe authors present a case report of a patient who developed anxiety, agitation, suicidal and homicidal ideation following brief exposure to metoclopramide.ResultsThe adverse effects of agitation and homicidal ideation were temporally related to the starting and stopping of metoclopramide. The patient subsequently developed agitation without homicidal ideation when given a serotonergic antidepressant a week later, suggesting that serotonin handling may have played a significant role in causing the patient's symptoms.ConclusionsAlthough metoclopramide is well-known for its side effects related to dopamine blockade, its action at 5-HT3 and 5-HT4 receptors may also be clinically significant in the genesis of neuropsychiatric side effects, especially related to mood and behavior.
