In early 2009, the U.S. Food and Drug Administration (FDA) required that all manufacturers of metoclopramide products include a black box warning on their drug packaging. The catalyst for this mandate was the link between Reglan side effects (brand name of metoclopramide) and tardive dyskinesia, a debilitating repetitive movement disorder. In truth, TD is only one of many potential side effects of long-term or high-dose use of the drug. This article will provide an overview of tardive dyskinesia and other side effects that can manifest from chronic Reglan use.
CNS Side Effects
It is estimated that 1 in 10 patients who receive a normal dosage (i.e. 10 mg) of metoclopramide will experience side effects related to the central nervous system. These can include drowsiness, exhaustion, or a perpetual restlessness. In some cases, patients might experience headaches, dizziness, and even depression, though these symptoms occur less often.
Symptoms Similar To Parkinson's Disease
Many people who have taken Reglan for periods exceeding twelve weeks have developed symptoms that are similar to Parkinson's disease. For example, they will often display cogwheel rigidity, a condition in which the patient's limb shows resistance to movement, but yields in step-like fashion. Tremors, muscular stiffness, and a "mask face" (known as hypomimia) can also manifest.
Neuroleptic Malignant Syndrome
In rare cases of chronic metoclopramide use, neuroleptic malignant syndrome (NMS) will present. This is a neurological condition that is potentially fatal. Symptoms can include muscular rigidity, fever, delirium, and dysautonomia. The latter symptom typically manifests as a combination of fatigue, thirst, anxiety, and vertigo. In severe cases of NMS, a patient might suffer from hyperthermia, a condition in which the body can overheat to the point of collapse.
Tardive Dyskinesia
Of all the potential side effects that can result from long-term use of drugs containing metoclopramide, tardive dyskinesia is one of the most common. It is also one of the most tragic. Patients who suffer from TD are forced to cope with a number of involuntary movements in their face and hands. Their eyes blink rapidly; their face grimaces uncontrollably; their lips pucker, smack, and purse; their tongue protrudes repetitively. All of these movements are reflexive and cannot be controlled.
Unfortunately, tardive dyskinesia is frequently incurable. It can be treated on a case-by-case basis, but treatment is administered to help lessen the impact of the symptoms, not cure the disorder. In some patients, the symptoms may become less pronounced or disappear altogether once Reglan use is discontinued. However, that is not always the case. Many victims must cope with the outward manifestations for the remainder of their lives.
Holding Reglan Manufacturers Accountable
One of the most startling recent revelations is that metoclopramide manufacturers may have been aware of the health dangers posed by their products even as they promoted their use. Evidence strongly suggests they not only were aware that long-term use of Reglan could lead to tardive dyskinesia, but they were also willing to downplay that risk. Several Reglan lawsuits have already been filed in order to hold these manufacturers accountable for their negligence.
Being diagnosed with a neurological disorder that has developed from chronic use of metoclopramide products is tragic. For some, it means a lifetime of medical bills, rehabilitation, and suffering.
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