İlçioğlu Ekici Gökçen, Şenses Dinç Gülser, Çıtak Kurt Ayşegül Neşe
Department of Child and Adolescent Psychiatry, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara, Türkiye.
Department of Child and Adolescent Psychiatry, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye.
Turk J Pediatr. 2024 Dec 25;66(6):775-780. doi: 10.24953/turkjpediatr.2024.5319.
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.
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.
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.
甲氧氯普胺是一种用于止吐的多巴胺拮抗剂，可引发神经精神方面的不良反应，包括锥体外系症状，在少数情况下还会引发急性精神病。尽管有老年患者因甲氧氯普胺诱发精神病的报道，但据我们所知，尚无儿童发生此类事件的记录。
本病例报告描述了一名11岁女孩，有轻度智力残疾和注意力缺陷多动障碍病史，每天服用10毫克哌甲酯。她因急性胃肠道症状前往急诊科就诊，在服用常规剂量哌甲酯的同时，还服用了两片甲氧氯普胺。随后，她出现了精神病症状、行为紊乱和躁动。全面的医学评估排除了其他器质性病变，最终诊断为甲氧氯普胺诱发的快速起病型精神病。这一持续约两周的精神病发作，经低剂量抗精神病药物治疗后得到缓解。
儿童，尤其是患有神经发育障碍的儿童，更容易出现各种副作用。因此，本报告强调了谨慎进行药物管理的必要性。此外，据我们所知，本病例是首例记录儿童因甲氧氯普胺诱发急性精神病的病例，对科学文献具有重要贡献。
