From the Guidelines
Domperidone is not typically associated with causing olfactory hallucinations, as it has limited ability to cross the blood-brain barrier, reducing its central nervous system effects. While domperidone is a dopamine receptor antagonist primarily used to treat nausea, vomiting, and gastroparesis, its side effect profile typically includes headache, dry mouth, abdominal cramps, and rarely extrapyramidal symptoms, as noted in a recent clinical practice update on management of medically refractory gastroparesis 1. Olfactory hallucinations (smelling things that aren't there) are not commonly reported with domperidone use.
Some key points to consider when evaluating the potential for domperidone to cause olfactory hallucinations include:
- The mechanism of action of domperidone, which involves blocking dopamine receptors in the gastrointestinal tract with minimal central nervous system penetration, as discussed in the context of managing gastroparesis 1
- The typical side effect profile of domperidone, which does not commonly include olfactory hallucinations, but rather more peripheral effects like headache and abdominal cramps 1
- The importance of considering other potential causes of olfactory hallucinations, such as neurological conditions, other medications, or psychiatric disorders, if a patient reports such symptoms while taking domperidone
Given the current evidence, it is reasonable to conclude that domperidone is not a common cause of olfactory hallucinations, and any unusual sensory experiences reported by patients taking this medication should be thoroughly evaluated for other potential causes, as suggested by the clinical practice update on gastroparesis management 1.
From the Research
Olfactory Hallucinations and Domperidone
- There is no direct evidence to suggest that domperidone causes olfactory hallucinations 2, 3, 4, 5, 6.
- The studies provided focus on the pharmacological activity, pharmacokinetics, and therapeutic efficacy of domperidone, as well as its effects on the central nervous system and dopamine receptors 3, 4, 5.
- One study mentions the effects of domperidone on dopaminergic neurons in the rat brain, including those in the olfactory tubercle, but does not discuss olfactory hallucinations 5.
- Another study reports a case of domperidone-induced tardive dyskinesia and withdrawal psychosis in an elderly woman with dementia, but does not mention olfactory hallucinations 6.
- The only study that discusses olfactory hallucinations is a case report of a patient with olfactory reference syndrome, which was treated with aripiprazole, not domperidone 2.