Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report

Ryohei Igata, Hikaru Hori, Kiyokazu Atake, Asuka Katsuki, Jun Nakamura Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan Abstract: A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around...

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Autores principales:	Igata R, Hori H, Atake K, Katsuki A, Nakamura J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	metoclopramide 　paroxetine extrapyramidal symptoms SSRI hyperprolactinemia depression Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/453177af52324eb9bc095448d5984416
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spelling	oai:doaj.org-article:453177af52324eb9bc095448d59844162021-12-02T06:01:42ZAdding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report1178-2021https://doaj.org/article/453177af52324eb9bc095448d59844162016-09-01T00:00:00Zhttps://www.dovepress.com/adding-metoclopramide-to-paroxetine-induced-extrapyramidal-symptoms-an-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Ryohei Igata, Hikaru Hori, Kiyokazu Atake, Asuka Katsuki, Jun Nakamura Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan Abstract: A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels. Keywords: metoclopramide, paroxetine, extrapyramidal symptoms, SSRI, hyperprolactinemia, depressionIgata RHori HAtake KKatsuki ANakamura JDove Medical Pressarticlemetoclopramide　paroxetineextrapyramidal symptomsSSRIhyperprolactinemiadepressionNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 12, Pp 2279-2281 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	metoclopramide 　paroxetine extrapyramidal symptoms SSRI hyperprolactinemia depression Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	metoclopramide 　paroxetine extrapyramidal symptoms SSRI hyperprolactinemia depression Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Igata R Hori H Atake K Katsuki A Nakamura J Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
description	Ryohei Igata, Hikaru Hori, Kiyokazu Atake, Asuka Katsuki, Jun Nakamura Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan Abstract: A 54-year-old Japanese woman was diagnosed with major depressive disorder and prescribed paroxetine 20 mg/day. In around May 2013, the patient experienced gastric discomfort, so metoclopramide was prescribed. Beginning on June 4, 2013, the patient was given metoclopramide, 10 mg intravenously, twice per week. On the seventh day after beginning metoclopramide, facial hot flushes, increased sweating, muscle rigidity, and galactorrhea were noted. Extrapyramidal symptoms (EPS) rapidly subsided in response to an intramuscular injection of biperiden. Blood biochemical tests revealed an elevated serum prolactin level of 44 ng/mL. After stopping metoclopramide, EPS disappeared. Serum prolactin level decreased to 15 ng/mL after 4 weeks. In our case, although no adverse reactions had previously occurred following the administration of metoclopramide, the patient developed EPS and hyperprolactinemia following the administration of this antiemetic in combination with paroxetine. Paroxetine and metoclopramide are mainly metabolized by CYP2D6, and they are inhibitors for CYP2D6. We report a case with EPS and hyperprolactinemia whose plasma paroxetine and metoclopramide level rapidly increased after the addition of metoclopramide. Our experience warrants the issuing of a precaution that adverse reactions may arise following the coadministration of metoclopramide and paroxetine even at their respective standard dose levels. Keywords: metoclopramide, paroxetine, extrapyramidal symptoms, SSRI, hyperprolactinemia, depression
format	article
author	Igata R Hori H Atake K Katsuki A Nakamura J
author_facet	Igata R Hori H Atake K Katsuki A Nakamura J
author_sort	Igata R
title	Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
title_short	Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
title_full	Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
title_fullStr	Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
title_full_unstemmed	Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
title_sort	adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/453177af52324eb9bc095448d5984416
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Adding metoclopramide to paroxetine induced extrapyramidal symptoms and hyperprolactinemia in a depressed woman: a case report

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