To the Editor: Metoclopramide is a dopamine-receptor antagonist FDA approved for the treatment of nausea, vomiting, and diabetic gastroparesis.1 In addition to its effect on the gastrointestinal tract, metoclopramide crosses the blood–brain barrier to antagonize dopamine type-2 (D2) receptors in the chemoreceptor trigger zone. However, metoclopramide also antagonizes D2 receptors in the nigrostriatal and striatopallidal pathways, similar to antipsychotics, which may lead to extrapyramidal side effects (EPS), including tardive dyskinesia (TD). Respiratory dyskinesia (RD) is a respiratory manifestation of TD and can present as irregular respiration, dyspnea, gasping, or abnormal esophageal movements.2 Metoclopramide has a black box warning for TD associated with long-term use. There have also been case reports of worsening dyskinesias upon metoclopramide discontinuation.3,4 Therefore, it is feasible that metoclopramide can cause a wearing-off respiratory dyskinesia. Here we describe the first case of RD after metoclopramide discontinuation.