Extrapyramidal symptoms (EPS) have been associated with which medication?

Extrapyramidal symptoms (EPS) are movement disorders that can occur as side effects of certain medications, particularly those that affect dopamine pathways in the brain. Metoclopramide is a dopamine antagonist, specifically blocking the D2 receptors in the central nervous system, which can lead to disruption of normal motor control and result in EPS. This is why it is well-known for this potential side effect, especially when used at higher doses or for prolonged periods.

In contrast, sucralfate is primarily used as a protective agent for the gastrointestinal tract and does not interact with dopamine pathways. Aprepitant is a substance P/neurokinin-1 receptor antagonist used mainly for nausea and vomiting associated with chemotherapy and is not associated with EPS. Bisacodyl is a laxative that works by stimulating bowel movements and has no connection to the dopaminergic system. This clear distinction in the mechanisms and use of these drugs explains why metoclopramide is the medication associated with extrapyramidal symptoms.