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Reglan (Metoclopramide)


Horns85
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I don't know if anyone here has any experience w/ Reglan before. My brother was put on this after a routine endoscopy and a misdiagnosis of gastroparesis(spelling?). After about 2 weeks of taking it he quit cold turkey per his doctor to avoid any Tardive Dyskinesia.

 

Since quitting, he has reported problems very similar to what we all are going through in AD WD. Waking up at first light, anxiety,depression,cortisol spikes, blurred vision.

 

Does anyone have any experience with this drug? Is this a common problem? Should he have tapered this drug?

 

His doc is no help.

 

Any replies are greatly appreciated because I really feel for him. Thanks!

Lexapro from October 2012-October 2014

10mg from Oct 2012-Feb 201320mg from Feb 2013-June 201310mg from July 2013-April 2014
Began taper via liquid Lexapro from April 2014-September 2014(Roughly 6 month taper)---0.00 on Oct 1 2014--WD began in December 2014

--------------------------------------------------------------------------------------------

Reinstated to 10mg - 10mg Tablet October 15, 2015 - Stable by Mid-January, 2016

2016 - 9mg 3/26/16....8mg 5/11/16....7mg 7/05/16....6mg 8/26/16....5mg 10/31/16

2017 - 4mg 3/06/17....3mg 6/24/17....2mg 9/07/17...1.25mg 10/21/17....1mg 11/04/2017

2018 - 0.75mg 1/21/18....0.5mg 2/18/18....0.25mg 3/13/18....0.125mg 3/27/18....0.000 4/9/18

 

Supplements - 15B probiotic on and off. Usually helps w/ mood but sometimes is too activating.

 

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http://en.wikipedia.org/wiki/Metoclopramide
 


Common adverse drug reactions (ADRs) associated with metoclopramide therapy include restlessness (akathisia), and focal dystonia. Infrequent ADRs include hypertension, hypotension, hyperprolactinaemia leading to galactorrhea, constipation, depression, headache, and extrapyramidal effects such as oculogyric crisis. Rare but serious ADRs associated with metoclopramide therapy include agranulocytosis, supraventricular tachycardia, hyperaldosteronism, neuroleptic malignant syndrome, akathisia and tardive dyskinesia.%5B8%5D
 
Metoclopramide may be the most common cause of drug-induced movement disorders.%5B13%5D The risk of extrapyramidal effects is increased in people under 20 years of age, and with high-dose or prolonged therapy.%5B7%5D%5B8%5D Tardive dyskinesia may be persistent and irreversible in some patients. The majority of reports of tardive dyskinesia occur in people who have used metoclopramide for more than three months.%5B13%5D Consequently, the US Food and Drug Administration (FDA) recommends that metoclopramide be used for short-term treatment, preferably less than 12 weeks. In 2009, the FDA required all manufacturers of metoclopramide to issue a black box warning regarding the risk of tardive dyskinesia with chronic or high-dose use of the drug.%5B13%5D
 
Dystonic reactions may be treated with benzatropine, diphenhydramine, trihexyphenidyl, or procyclidine. Symptoms usually subside with benadryl (diphenhydramine hydrochloride) or benzatropine injected intramuscularly.%5B14%5D Agents in the benzodiazepine class of drugs may be helpful, but benefits are usually modest and side effects of sedation and weakness can be problematic.%5B15%5D
 
In some cases, the akathisia effects of metoclopramide are directly related to the infusion rate when the drug is administered intravenously. Side effects were usually seen in the first 15 minutes after the dose of metoclopramide.%5B16%5D

 
http://www.tardivedyskinesia.com/reglan/risk-factors/side-effects.php
 

Reglan, one of the trade names for the medical drug metoclopramide, is classified as a dopamine antagonist. ....

The Body's Internet
....There are several different kinds of dopamine and dopamine receptors, each of which deal with specific bodily and/or neural functions. Medications that are dopamine antagonists block these signals for specific dopamine receptors and have the potential to cause tardive dyskinesia.

Antipsychotics and Other Medications
Dopamine antagonists were originally developed in the 1950s and '60s in order to treat psychiatric patients. These medications targeted a specific dopamine receptor known as D2, which is responsible for the control of certain muscle operations and neural feedback mechanisms.
 
Metoclopramide was initially developed for this purpose, but was found to be less effective than many other antipsychotic drugs currently in use at the time. However, it was effective in controlling certain gastrointestinal disorders by blocking dopamine receptors of the digestive system. Symptoms that could be controlled included heartburn, acid reflux and gastroparesis, which is partial or complete paralysis of the stomach.

Problems Arise with Metoclopramide (Reglan)
Metoclopramide became popular in the late 1990s after its predecessor, Cisapride, was found to cause serious side effects. Unfortunately for many patients who had already begun to take metoclopramide, a study published in 2004 found the medication could cause a movement disorder known as tardive dyskinesia.
 
These symptoms were more likely to occur in older female patients who had taken the drug for an extended period of time, but others taking the drug were at risk as well. This ultimately led to action by the Food and Drug Administration, requiring a "black box" warning on all packages of Reglan.
....

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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I am sorry that your brother has had a reaction to the drug, it is terrible how they give out psychotropic drugs for just about anything! 

I hope he is feeling better now, it could take some time but he will get better. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Wow one more drug I took without knowing the side effects... some days I think it is a miracle I am still alive.  Thank heavens for the internet now look up you drugs BEFORE you take them. 

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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Metoclopramide and prochlorperazine are two dopamine receptor antagonists (i.e. anti-psychotics) that are commonly used as anti-emetics (i.e. to treat nausea and vomiting). 

 

I believe a lot of doctors do not realise that these meds are anti-psychotics.  Most meds have multiple effects, and the manufacturers choose the effect they want to market the drug for as the main effect, and the others as "side" effects.  So the doctors think med A is an anti-nausea med, and med B is an anti-psychotic med, without realising they are in the same family, like chemical "cousins", with most of the same effects.

 

However, it seems that your brother's doctor was well aware of the risk of TD (a risk associated with anti-psychotics in general).  If your brother took metoclopramide for only two weeks, it is very likely his withdrawal symptoms will be short-lived.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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