Metoclopramide-Induced Acute Dystonia: Data From a Pediatric Emergency Unit.

Yarar C., Yakut A., Carman K. B., Sahin S., Kocak O., Ozkan S., ...More

Pediatric emergency care, vol.37, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 37
  • Publication Date: 2021
  • Doi Number: 10.1097/pec.0000000000001960
  • Journal Name: Pediatric emergency care
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Keywords: metoclopramide, dystonia, antiemetic agents, off-label drugs, MOVEMENT-DISORDERS, CHILDREN
  • Eskisehir Osmangazi University Affiliated: Yes


Objectives Metoclopramide is a commonly used medication in pediatric practice, and dystonia is a common adverse effect of it. The present study aims to evaluate the clinical characteristics of metoclopramide-induced acute dystonic reactions (MIADRs) in pediatric patients admitted to the pediatric emergency unit. Methods Twenty-eight patients were admitted with MIADRs between June 2004 and April 2016; they were enrolled into the study retrospectively. Results The study group was composed of 13 females and 15 males with the mean +/- SD age of the females higher than that of the males, 12.3 +/- 4.5 and 7.8 +/- 4.3 years, respectively. Only 9 (32.1%) of the patients were diagnosed as MIADRs at the time of admission. Seventeen patients (60.7%) received over the recommended daily dose of metoclopramide. Dystonia was focal in most of the patients, with the most affected parts consisting of the neck, eyes, and orolingual regions. In 9 of the patients, the dystonia was episodic in nature. Pharmacological treatment was used for 18 patients. No patients died, and none suffered long-term injury related to MIADRs. Conclusions Metoclopramide administration may be associated with the occurrence of acute dystonic reaction. Metoclopramide-induced acute dystonic reactions may be misdiagnosed, so detailed medical history gathering and a high index of suspicion are warranted. Our data suggest that MIADRs may be dose related and that there may be age- and sex-related differences in the epidemiology of MIADRs.