Tardive dyskinesia in Huntington disease patients on Reglan
July 10th, 2009 by Jennifer Walker-Journey
Patients with Huntington disease (HD), a rare degenerative disorder of the central nervous system, have often been prescribed Reglan (metoclopramide) for the treatment of gastric problems even though the medication’s label says people with a history of depression, Parkinson’s disease or a movement disorder, and epilepsy or other seizure disorder should not take the drug.
HD symptoms include changes in personality, cognition and physical skills. Almost all patients with HD exhibit physical symptoms such as jerky, random and uncontrollable movements. Many HD patients who were prescribed Reglan “have experienced not only symptoms of neuroleptic malignant syndrome (NMS) and/or Tardive Dyskinesia, but (also) hallucinations, paranoia, suicidal thoughts, severe anger outburts, etc.,” according to Jean E. Miller, a contributor editor for HD Lighthouse, an information center and community for patients with HD and their family members. “In one HD patient, the serious side effects still hadn’t gone away 18 months after taking Reglan.”
Earlier this year the Food and Drug Administration ordered the makers of Reglan (metoclopramide) to include a black box warning on the product label warning of the risk of Tardive Dyskinesia with long-term, high-dose use of the drug. Tardive Dyskinesia is a condition in which the body moves repetitively and uncontrollably. The condition often continues even after the medication has been discontinued.
Miller says she hopes the black box warning on Reglan will make physicians more cautious when prescribing the medication for patients with HD. She also urges familys of HD patients to “exercise caution when a physician wants this medication prescribed, especially for those in the later stages of HD or on feeding tubes.”