Metoclopramide: an analysis of inappropriate long-term use in the elderly

OBJECTIVE: To present a case of possible metoclopramide-induced tardive dyskinesia and document the frequent use of metoclopramide for inappropriate lengths of treatment in elderly, ambulatory subjects. DESIGN: Descriptive study that identified long-term users of metoclopramide among a population of 4515 elderly subjects. SETTING: Participants in an ambulatory health-screening program in Florida (Florida Geriatric Research Program). PARTICIPANTS: Individuals (2898 women and 1617 men) over the age of 65 years who volunteered for annual health screening. INTERVENTIONS: All medication histories for participants were reviewed to identify subjects who reported metoclopramide use on at least one visit to the program. RESULTS: Thirty-four participants (0.75 percent) reported the use of metoclopramide during at least one visit. Eleven subjects (32.4 percent) reported that they had used this drug for longer than one year. Nine of the 34 subjects (26.5 percent) also reported the use of metoclopramide at their next annual visit. CONCLUSIONS: Results from this study suggest that metoclopramide is frequently prescribed inappropriately to treat gastrointestinal disorders. Long-term use of this drug exposes patients to an unnecessary risk of adverse drug reactions.

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				C. Kenney, C. Hunter, A. Davidson, and J. Jankovic Metoclopramide, an Increasingly Recognized Cause of Tardive Dyskinesia J. Clin. Pharmacol., March 1, 2008; 48(3): 379 - 384. [Full Text] [PDF]