Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report

Background. Metoclopramide, a dopamine antagonist employed for its antiemetic effects, can precipitate neuropsychiatric adverse effects, including extrapyramidal symptoms and, in a few instances, acute psychosis. Although there have been reports of metoclopramide-induced psychosis in elderly indivi...

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Main Authors: Gökçen İlçioğlu Ekici, Gülser Şenses Dinç, Ayşegül Neşe Çıtak Kurt
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2024-12-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/5319
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author Gökçen İlçioğlu Ekici
Gülser Şenses Dinç
Ayşegül Neşe Çıtak Kurt
author_facet Gökçen İlçioğlu Ekici
Gülser Şenses Dinç
Ayşegül Neşe Çıtak Kurt
author_sort Gökçen İlçioğlu Ekici
collection DOAJ
description Background. Metoclopramide, a dopamine antagonist employed for its antiemetic effects, can precipitate neuropsychiatric adverse effects, including extrapyramidal symptoms and, in a few instances, acute psychosis. Although there have been reports of metoclopramide-induced psychosis in elderly individuals, there is no documentation of such incidents in children as far as we are aware. Case presentation. This case report describes an 11-year-old girl with a history of mild intellectual disability and attention deficit hyperactivity disorder, managed with 10 mg of methylphenidate daily. She presented to the emergency department with acute gastrointestinal symptoms and was administered two tablets of metoclopramide alongside her regular dose of methylphenidate. Subsequently, she developed psychotic symptoms, disorganized behavior, and agitation. An extensive medical evaluation ruled out other organic pathologies, leading to a diagnosis of rapid-onset psychosis induced by metoclopramide. The psychotic episode, which lasted approximately two weeks, resolved with low-dose antipsychotic treatment. Conclusions. Children, especially those with neurodevelopmental disorders, are more susceptible to a wide range of side effects. Therefore, this report highlights the necessity for careful pharmacological management. Additionally, this case represents a significant contribution to the scientific literature by being the first to document metoclopramide-induced acute psychosis in children to the best of our knowledge.
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spelling doaj-art-a592335a4baf48dc89ff2fe01c0ad1442025-08-20T02:55:42ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212024-12-0166610.24953/turkjpediatr.2024.5319Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case reportGökçen İlçioğlu Ekici0https://orcid.org/0000-0001-6245-396XGülser Şenses Dinç1https://orcid.org/0000-0001-5556-3175Ayşegül Neşe Çıtak Kurt2https://orcid.org/0000-0002-7277-3550Department of Child and Adolescent Psychiatry, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, TürkiyeDepartment of Child and Adolescent Psychiatry, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, TürkiyeDepartment of Pediatric Neurology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Türkiye Background. Metoclopramide, a dopamine antagonist employed for its antiemetic effects, can precipitate neuropsychiatric adverse effects, including extrapyramidal symptoms and, in a few instances, acute psychosis. Although there have been reports of metoclopramide-induced psychosis in elderly individuals, there is no documentation of such incidents in children as far as we are aware. Case presentation. This case report describes an 11-year-old girl with a history of mild intellectual disability and attention deficit hyperactivity disorder, managed with 10 mg of methylphenidate daily. She presented to the emergency department with acute gastrointestinal symptoms and was administered two tablets of metoclopramide alongside her regular dose of methylphenidate. Subsequently, she developed psychotic symptoms, disorganized behavior, and agitation. An extensive medical evaluation ruled out other organic pathologies, leading to a diagnosis of rapid-onset psychosis induced by metoclopramide. The psychotic episode, which lasted approximately two weeks, resolved with low-dose antipsychotic treatment. Conclusions. Children, especially those with neurodevelopmental disorders, are more susceptible to a wide range of side effects. Therefore, this report highlights the necessity for careful pharmacological management. Additionally, this case represents a significant contribution to the scientific literature by being the first to document metoclopramide-induced acute psychosis in children to the best of our knowledge. https://turkjpediatr.org/article/view/5319metoclopramideacute psychosischildrenadverse drug reactions
spellingShingle Gökçen İlçioğlu Ekici
Gülser Şenses Dinç
Ayşegül Neşe Çıtak Kurt
Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
The Turkish Journal of Pediatrics
metoclopramide
acute psychosis
children
adverse drug reactions
title Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
title_full Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
title_fullStr Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
title_full_unstemmed Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
title_short Metoclopramide-induced rapid-onset psychosis in a child with methylphenidate use: a case report
title_sort metoclopramide induced rapid onset psychosis in a child with methylphenidate use a case report
topic metoclopramide
acute psychosis
children
adverse drug reactions
url https://turkjpediatr.org/article/view/5319
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AT aysegulnesecıtakkurt metoclopramideinducedrapidonsetpsychosisinachildwithmethylphenidateuseacasereport