THE PREVALENCE OF METOCLOPRAMIDE-INDUCED TARDIVE-DYSKINESIA AND ACUTE EXTRAPYRAMIDAL MOVEMENT-DISORDERS
THE PREVALENCE OF METOCLOPRAMIDE-INDUCED TARDIVE-DYSKINESIA AND ACUTE EXTRAPYRAMIDAL MOVEMENT-DISORDERS
复制标题
DOI：
10.1001/archinte.153.12.1469
复制
发表时间：
1993-06-28
影响因子：
--
通讯作者：
MCCALL, AL
中科院分区：
文献类型：
--
作者：
GANZINI, L;CASEY, DE;MCCALL, AL
背景资料：盐酸甲氧氯普胺是一种用于治疗胃病的多巴胺受体拮抗剂，据报道可引起锥体外系运动障碍。本研究的目的是（1）确定甲氧氯普胺治疗患者迟发性运动障碍和急性锥体外系运动综合征（包括静坐不能、急性肌张力障碍和药物诱导的帕金森综合征）的患病率和严重程度，（2）比较甲氧氯普胺治疗的糖尿病患者和非糖尿病患者迟发性运动障碍的患病率和严重程度。从波特兰（俄勒冈州）退伍军人事务医疗中心药房收到的甲氧氯普胺治疗患者名单中，53例患者符合入选标准，51例（96%）同意参加。对照组由从波特兰退伍军人事务医疗中心门诊抽取的便利样本组成，这些样本与年龄（+/-10岁）、性别和是否患有糖尿病的受试者相匹配。在联系的61例潜在对照中，51例（84%）同意参与。甲氧氯普胺治疗的受试者和对照组由一名对所有诊断和治疗均“盲”的评估者观察。评估者进行了标准化的检查，用于引出迟发性运动障碍和急性锥体外系运动syndrome.Results的体征和症状：迟发性运动障碍的相对危险度为1.67（95%置信区间，0.93至2.97），药物引起的帕金森综合征的相对危险度为4.0（95%置信区间，1.5至10.5）。甲氧氯普胺治疗的患者迟发性运动障碍、药物诱发的帕金森综合征和主观静坐不能的严重程度显著高于对照组。甲氧氯普胺的使用与amorphin受损和苯二氮卓类药物的使用增加有关。甲氧氯普胺治疗的糖尿病患者有显着更大的迟发性运动障碍的严重程度比甲氧氯普胺治疗nondiabetics.Conclusions：甲氧氯普胺的使用与显着增加的患病率和严重程度的几个锥体外系运动障碍。
Background: Metoclopramide hydrochloride, a neuroleptic dopamine receptor antagonist used to treat gastric ailments, is reported to cause extrapyramidal movement disorders. The goals of this study were (1) to determine the prevalence and severity of tardive dyskinesia and acute extrapyramidal movement syndromes including akathisia, acute dystonia, and drug-induced parkinsonism in metoclopramide-treated patients and (2) to compare the prevalence and severity of tardive dyskinesia in metoclopramide-treated diabetics and nondiabetics.Methods: From a list of metoclopramide-treated patients received from the Portland (Ore) Veterans Affairs Medical Center pharmacy, 53 patients met inclusion criteria and 51 (96%) agreed to participate. Controls consisted of a convenience sample drawn from the Portland Veterans Affairs Medical Center Outpatient Clinic who were matched to subjects on age (+/-10 years), gender, and presence or absence of diabetes. Of 61 potential controls contacted, 51 (84%) agreed to participate. Metoclopramide-treated subjects and controls were seen by a rater who was ''blind'' to all diagnoses and treatments. The rater performed a standardized examination used to elicit signs and symptoms of tardive dyskinesia and acute extrapyramidal movement syndromes.Results: The relative risk for tardive dyskinesia was 1.67 (95% confidence interval, 0.93 to 2.97), and the relative risk for drug-induced parkinsonism was 4.0 (95% confidence interval, 1.5 to 10.5). Metoclopramide-treated patients had significantly greater severity of tardive dyskinesia, drug-induced parkinsonism, and subjective akathisia than controls. Use of metoclopramide was associated with impairment in ambulation and increased use of benzodiazepines. Metoclopramide-treated diabetics had significantly greater severity of tardive dyskinesia than metoclopramide-treated nondiabetics.Conclusions: Metoclopramide use is associated with a significantly increased prevalence and severity of several extrapyramidal movement disorders.