Rapid, Repetitive Spastic Facial Movements Are A Concern Especially For Older Women
Though metoclopramide side effects were initially considered mild by the medical industry, more recently links to serious movement disorders have brought Reglan under increased scrutiny. The drug was initially approved in 1985, and consumers commonly reported instances of decreased energy, diarrhea, dizziness, drowsiness, headache, heartburn, nausea, restlessness, fatigue, and trouble sleeping, all indicated in the warnings already present on the drug’s label. However, some consumers reported extrapyramidal reactions, as well as difficulty breathing or skin irritation, confusion, abnormal thinking, unusual weight gain, sudden and increased sweating, shortness of breath, hallucinations, loss of bladder control, decreased sexual ability, changes in heart beat or heart rhythms, seizures, mental and mood changes including increased depression or anxiety, and suicidal thoughts or actions. Many of these reports coincide with symptoms experienced with other similar drugs.
A series of diseases have also been linked to the medication, including Akathisia, Dystonia, blepharospasm, Parkinson’s disease-like symptoms, neuroleptic malignant syndrome, and tardive dyskinesia (TD). High dosage appears to increase the risk of these illnesses, and many are marked by motor restlessness. Because of the occurrence of these serious metoclopramide side effects, the FDA required the makers of the drug to include a “black box” warning on the prescription to ensure that patients were well aware of the precautions necessary before treatment.
The warnings regarding side effects of Reglan - the branded name of the drug - indicate the risks of developing serious health problems, including TD. This particular disease is directly linked to use of the drug, which was originally prescribed as a medication for heartburn and considered safe; it can exhibit symptoms long after first use. The symptoms associated with TD are tongue thrusting, cheek puffing, jaw movement, speech problems, and rapid blinking. With a progression of the illness, general motor restlessness increases and moves to the trunk and extremities. Patients with advanced symptoms experience head nodding, rocking of the upper torso, shoulder shrugging, diaphragm contractions, and hip rocking.
Another disease linked to the use of neuroleptics is neuroleptic malignant syndrome. Around .2% of patients taking the drug, whether as an oral solution, tablet, dissolving tablet, or injection, experienced signs that indicate the presence of this disorder. Initial signs of the disease include high fever and muscle rigidity followed by general instability of the autonomic nervous system; what results is irregular blood pressure, cognitive issues, delirium, and occasionally coma. Without medical treatment the disease can be fatal. Fatalities occur in 5-15% of patients.
Both diseases have a high incidence of mitigating adverse effects when patients ceased use of the drug. However, because of the gravity of these issues - some of which are irreversible - it is only with extreme precautions that doctors should prescribe it. According to Janet Woodcock, the director of the FDA’s Center for Drug Evaluation and Research, "The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk.”
The most important first step if you believe you are experiencing any of these conditions is to contact a doctor. A positive diagnosis is important, and you should let your physician know what dosage you have taken and which method of administration of the prescription.
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