A CASE REPORT OF LEVOSULPIRIDE INDUCED PARKINSONISM

Cijy John, Shinto Sen, Aparna Grigorious, Lakshmi R.* and Kevin Reji

ABSTRACT

Levosulpiride is a prokinetic drug frequently prescribed for gastric motility disorders. Although it is commonly used to treat these conditions, its potential to cause Parkinsonism and acute dystonia as significant adverse effects is often under-recognized.[1] Levosulpiride is an enantiomer of sulpiride with anti-dopaminergic activity at D2 receptors and agonistic activity at 5HT4 receptors. By inhibiting D2 receptors in the gastrointestinal system, it increases gastric and gallbladder motility and enhances the tone of the lower oesophageal sphincter. Its central action on the area postrema also makes it a potent antiemetic. Levosulpiride is used to treat dyspepsia, gastroparesis, burning mouth syndrome, cataplexy, acute labyrinthine dysfunction, and premature ejaculation. It is also recommended for psychiatric illnesses such as depressive disorders, somatoform disorder, and both positive and negative symptoms of schizophrenia. The drug remains un metabolized and is excreted in urine unchanged, which reduces the potential for drug interactions. Animal studies have not found any teratogenic, mutagenic or oncogenic potential, but no studies have confidently assessed its use during pregnancy. As levosulpiride is excreted in breast milk, its use is highly advised against in lactating mothers.[2] Here we present a case involving a 45year-old man who developed levosulpride induced parkinsonism, highlighting a rare side effect of levosulpiride that is documented in medical literature. Upon the discontinuation of levosulpiride, the symptoms resolved.

Keywords: Levosulpiride, parkinsonism, acute dystonia, prokinetic drug.