Extrapyramidal side effects after metoclopramide administration in a post-anesthesia care unit: A case report / 대한마취과학회지

Although the incidence of extrapyramidal reactions associated with metoclopramide has been reported to be approximately 0.2%, such reactions are rare in the anesthetic field. Several anesthetic adjuvants, including ondansetron and pregabalin, have also been associated with extrapyramidal side effect. Here, the authors report the case of a 47-year-old patient, previously administered pregabalin and ondansetron, who developed extrapyramidal side effects after a single injection of metoclopramide (10 mg) in a post-anesthesia care unit.

Subjective Quality of Life in Schizophrenic Patients Receiving Atypical Antipsychotics: Relationship to Psychopathology, Adverse Drug Effects and Subjective Response to Drug / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. METHODS: One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. RESULTS: In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score of KmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score of KmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. CONCLUSION: The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.

A Case of Metronome Pisa Syndrome in Risperidone Therapy / 신경정신의학

The Pisa syndrome is a rare extrapyramidal side effect caused by neuroleptic treatment and its characteristics are twisting and bending to one side of the upper thorax, the neck and the head. When its chatacteristics show both sides, we call it 'Metronome Pisa syndrome'. We report the case of a 53-year-old woman who suffered Metronome Pisa syndrome following risperidone therapy. Risperidone therapy in old ages should be cautious even if its dosage is minimal.

Four Cases of Pisa Syndrome in Risperidone Therapy

The Pisa syndrome is a rare extrapyramidal side effect caused by neuroleptic treatment. Its characteristics are the twist-ing and bending to one side of the upper thorax, the neck, and the head. To our knowledge, there have been no reports of Pisa syndrome in risperidone therapy. We report four male patients with Pisa syndrome in risperidone therapy. Significant points to be noted here are the absence of any extrapyramidal symptoms prior to risperidone therapy, occur-rence in risperidone therapy with small dosages, and delayed spontaneous recovery on discontinuation of risperidone.