Levosulpiride is a substituted
benzamide that is widely used for the management of
dyspepsia and
emesis. However, little is known about
levosulpiride-induced
movement disorders (LIM). The aim of this study was to investigate the clinical characteristics of patients with LIM. Among 132 consecutive patients who were diagnosed with
drug-induced
movement disorders between January 2002 and March 2008, 91 patients with LIM were identified and their medical records reviewed. Seventy-eight (85.7%) patients were aged more than 60 years. The most common LIM was
parkinsonism (LIP) (n = 85, 93.4%), followed by
tardive dyskinesia (n = 9, 9.9%) and isolated
tremor (n = 3, 3.3%). Twenty-one (24.7%) of the 85 patients with LIP were rated as Hoehn and Yahr stage III-V. The oro-lingual area was the only body part that was involved by
tardive dyskinesia. LIM persisted after withdrawal of
levosulpiride in 48.1% of patients with LIP, 66.7% with
dyskinesia, and none with isolated
tremor. None of clinical and MRI features predicted the reversibility of LIP.
Levosulpiride frequently causes
drug-induced
movement disorders, presenting mainly with LIP followed by lower face
dyskinesia. The symptoms are often severe, and irreversible even after the withdrawal of
levosulpiride. Physicians should be cautious in using
levosulpiride, especially in elderly patients.