Akathisia metoclopramide

Metoclopramide crosses the BBB and has centrally-mediated adverse effects. Young children and the elderly are especially susceptible to these effects, which include somnolence, reduced mental acuity, anxiety, depression, and EPS (akathisia, dystonia, and tardive dyskinesia).30 The overall incidence of adverse effects is estimated to be 10% to 20%.1... 

Metoclopramide can cause adverse effects such as sedation, akathisia (motor restlessness), involuntary movements, diarrhea, and dizziness. The extrapyramidal reactions, which are more common in patients < 30 years old, can be relieved by intravenous or oral diphenhydramine or benztropine (Cogentin). 

Prochlorperazine (Compazine, and others) can be effective for prevention of vomiting due to cancer chemotherapy, but is generally less so than dexamethasone or metoclopramide. Phenothiazines can cause orthostatic hypotension, sedation, dystonic reactions, and akathisia. 

The efficacy and adverse effects of domperidone and metoclopramide have been compared in a double-bhnd, multicenter, randomized trial in 93 insuhn-dependent diabetics with symptomatic gastroparesis (7). Domperidone 20 mg qds and metoclopramide 10 mg qds, for 4 weeks, were equally effective in alleviating sjmptoms of gastroparesis. Somnolence, akathisia, anxiety, and depression were more... 

Regan LA, Hoffman RS, Nelson LS. Slower infusion of metoclopramide decreases the rate of akathisia. Am J Emerg Med 2009 27 475-80. 

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