Tardive dyskinesia

Metoclopramide and Tardive Dyskinesia

Reglan and Tardive Dyskinesia

Metoclopramide (Reglan®), primarily used to treat symptoms of heartburn and nausea, has been linked to a severe neurological disorder known as tardive dyskinesia (pronounced tahr-div dis-ki-nee-zhuh), or TD. The condition can result from taking Reglan for even a relatively short period of time in high doses.

Tardive dyskinesia can be embarrassing for affected people, as they can no longer control the movements of their own bodies, and many file Reglan and tardive dyskinesia lawsuits. Symptoms include constant, uncontrollable actions of the mouth, tongue, jaw, cheeks, arms, legs, and hips. An acute case of tardive dyskinesia affecting the mouth can result in abnormal movement of the tongue more than 60 times per minute.

Symptoms of tardive dyskinesia include:

  • finger flicking
  • jaw movements (appears as a chewing or side-to-side jaw motion)
  • rapid eye blinking
  • repetitive, involuntary twisting movements of the arms, legs, fingers, or toes
  • smacking, puckering, and pursing of the lips
  • sticking the tongue in and out (tongue protrusion)
  • swaying movements of the trunk or hips (pelvic thrusting or twisting)
  • uncontrolled grimacing

Tardive dyskinesia can affect anyone, including infants and children—some of whom are prescribed Reglan so they spit up or vomit less, despite the risks of TD.

How is Tardive Dyskinesia Diagnosed?

Tardive dyskinesia is usually diagnosed following an extensive physical and neuropsychiatric evaluation by a doctor. This may include tests for blood cell counts, electrolyte levels, thyroid functions, and brain and body scans.

Tardive dyskinesia and its symptoms are also sometimes referred to as “extrapyramidal symptoms” (EPS) in the medical community. The term includes:

  • dystonias (muscle tension disorders)
  • various dyskinesias (movement disorders)

Reglan users may suffer from both muscle tension and movement disorders. Because the symptoms of TD may be worse or better depending on the day, the doctor may need to induce symptoms by distracting the patient and having a conversation with him or her while paying particular attention to the tongue and area around the mouth. The evaluation may need to be repeated within one week to support initial diagnosis.

Diagnosis in Infants and Children

Diagnosing TD in infants and children is difficult, as the condition can be confused with cerebral palsy, because infants with a Reglan movement disorder may arch their necks and backs, have spasms and seizures, and move their legs in a continual circular motion (similar to cycling). Children with TD may suffer repetitive movements of the mouth or arms. A doctor must make the diagnosis after performing extensive medical testing.

Tardive Dyskinesia Treatment

Unfortunately, TD is not easily treatable, so most doctors focus on the prevention of the condition. This involves discontinuing or reducing the use of the drug causing tardive dyskinesia. One study showed minimal improvement in TD victims treated with a specific form of vitamin E (called alpha-tocopherol), but unfortunately there is not a simple, effective solution for people suffering from serious cases of Reglan-related tardive dyskinesia.