Acute intoxication with domperidone

The severity of intoxications with domperidone and more generally with dopamine receptor antagonists (phenothiazines, butyrophenones, and benzamides) mainly lies in their neuroleptic effect.

Clinical features

• Diffuse or faciotruncal extrapyramidal syndrome
• Oculogyric crises (++ in children), consciousness disorders (! always investigate concomitant intake of psychotropic drugs in case of coma)
• Arterial hypotension and moderate respiratory depression, rare cases of cardiac disorders. Exceptionally described cardiorespiratory arrests, mainly in cases of rapid IV administration
• Risk of neuroleptic malignant syndrome

Therapeutic management - treatments

• Activated charcoal within the hour
• Symptomatic management
• In cases of extrapyramidal syndrome: ethopropazine or trihexyphenidyl

Author(s)

Dr. Shanan Khairi, MD

Bibliography

EMC, Traité de médecine AKOS, Elsevier, 2018