Metoclopramide-induced acute dystonic reactions may be associated with the CYP2D6 poor metaboliser status and pregnancy-related hormonal changes

Eng Wee Chua, Simon P. Harger, Martin A. Kennedy

Research output: Contribution to journalArticle

Abstract

We report two cases of metoclopramide-induced acute dystonia in pregnant women and consider the role of genetic variation in the pathogenesis of the adverse effect. By whole-gene sequencing, we found that both women were CYP2D6 poor metabolisers. We theorise that CYP2D6 governs the risk of metoclopramide-related acute dystonia through its role in the synthesis of serotonin, which inhibits the dopamine tone. The effect of CYP2D6 poor metabolism is exaggerated by rises in the oestrogen levels during pregnancy, as the hormone augments dopamine sensitivity. Together, the two factors may create a hyper-dopaminergic state that is easily upset by metoclopramide, resulting in acute dystonia.

Original languageEnglish
Article number931
JournalFrontiers in Pharmacology
Volume10
Issue numberJULY
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Cytochrome P-450 CYP2D6
Metoclopramide
Dystonia
Pregnancy
Dopamine
Pregnant Women
Serotonin
Estrogens
Hormones
Genes

Keywords

  • Acute dystonia
  • CYP2D6
  • Dopamine
  • Metoclopramide
  • Oestrogen
  • Poor metaboliser
  • Pregnancy

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Metoclopramide-induced acute dystonic reactions may be associated with the CYP2D6 poor metaboliser status and pregnancy-related hormonal changes. / Wee Chua, Eng; Harger, Simon P.; Kennedy, Martin A.

In: Frontiers in Pharmacology, Vol. 10, No. JULY, 931, 01.01.2019.

Research output: Contribution to journalArticle

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