CHRISTOPHER D. ADAMS, M.D.
To the editor: In their letter on metoclopramide and depression, Bottner and Tullio (1) recommend gradual dosage increases for patients manifesting depression while taking metoclopramide. The validity of these recommendations has been shown at our facility recently in two diabetic patients with gastroparesis.
Patient 1: A 38-year-old man with insulin-dependent diabetes mellitus for 12 years began having episodes of severe abdominal pain accompanied by adynamic ileus in 1979. Several surgical procedures were done to relieve this problem. Surgical findings included malrotation of the bowel, papillitis of the ampulla of Vater, and pancreatic fibrosis, but no other evidence of situs inversus.
ADAMS CD. Metoclopramide and Depression. Ann Intern Med. ;103:960. doi: 10.7326/0003-4819-103-6-960_1
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Published: Ann Intern Med. 1985;103(6_Part_1):960.
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