Reglan and Tardive Dyskinesia

by on April 17, 2012

Among the side effects of Reglan (metoclopramide), tardive dyskinesia (TD) is perhaps the most striking. In 2004, a study conducted by medical specialists from the Veteran’s Administration and the FDA revealed that metoclopramide increases the risk of TD. It stressed that the wide use of metoclopramide in today’s healthcare system may cause an increase in TD cases. The study further recommended that physicians carefully weigh the TD risk factors against the benefits when prescribing metoclopramide to patients.

Currently, metoclopramide is prescribed to over two million Americans.

What is Tardive Dyskinesia?

Tardive dyskinesia is a potentially irreversible side effect of Reglan that is characterized by uncontrollable movements of the muscles particularly of the extremities, face or tongue.

Some of the signs and symptoms of tardive dyskinesia include:

  • Facial twitch or grimacing
  • Lip smacking
  • Uncontrolled finger movement
  • Repetitive chewing
  • Tongue thrusting
  • Jaw swinging

The total cumulative dose and the duration of treatment increases the risk of developing TD.  In some cases, this condition can be permanent, and it is most likely to develop if a patient is taking this medication for longer than three months.

Reglan potentiates some other risk factors of TD that include diabetes, substance abuse, genetic predisposition, psychosis and organic brain dysfunction. Although these risk factors increase the possibility of developing TD, it is nearly impossible to predict whether a patient will develop metoclopramide-related TD.

Most cases of metoclopramide-induced TD are caused by prolonged use of the medication. As such, it is recommended to limit the use of this drug to no longer than 12 weeks. However, in rare cases where the medical condition requires treatment for more than 12 weeks, the therapeutic benefits must be weighed against the potential risks.

Prevent or Managing tardive dyskinesia

It is important to take Reglan strictly as prescribed by your healthcare provider. Usually, doctors limit the dose and duration of metoclopramide to prevent the development of TD. Be sure to discuss with your physician all the medications that you are taking. As much as possible, avoid taking medications, either prescription or OTC, and other substances that are known to interact with Reglan.

Use of metoclopramide should be stopped if the patient shows signs and symptoms of TD. If you experience any of the signs mentioned above while on Reglan, you should immediately seek medical consultation. Take note that there is no known treatment for diagnosed cases of TD although some cases of TD may go into partial or complete remission several weeks or months after metoclopramide is discontinued.

Regular medical evaluation while on Reglan treatment is vital in preventing the development of TD.