Nausea and vomiting is a common symptom of many ailments like viral gastroenteritis, food poisoning, stress, or even motion sickness. When patients visit overworked doctors, they are often prescribed Reglan to ease their symptoms. Is Reglan the best choice for you?
What is Reglan and Why is it Prescribed?
Reglan is an antiemetic, a gastroprokinetic agent, and increases lower esophageal sphincter tone. Reglan is commonly prescribed for nausea, vomiting, gastroparesis, and reflux. The medication relieves gastroparesis and reflux by encouraging the stomach to empty its contents orderly into the small intestine.1 The medication works as a D2 receptor antagonist and a 5-HT4 receptor agonist signaling the pyloric sphincter to relax and allow gastric chyme to pass through easier.2 D2 receptors are also found in the chemoreceptor trigger zone within the medulla oblongata in the brain and when stimulated it causes the stomach and esophagus to contract upward by stimulating muscles in the chest and thoracic diaphragm and weakens the lower esophageal sphincter leading to nausea and vomiting.3
Common side effects of Reglan include restlessness, drowsiness, fatigue, and focal dystonia. Some people even experience blood pressure regulation dysfunction, tardive dyskinesia, akathisia, neuroleptic malignant syndrome, and systemic allergic reactions.4 Reglan crosses the blood-brain barrier resulting in CNS side effects.5
I find tardive dyskinesia is one of the most worrying side effects associated with Reglan. It is a disease in which the body has permanent, involuntary, and repetitive body movements. The FDA issued a black box warning on Reglan stating that there is a strong indication Reglan can cause tardive dyskinesia.6 The longer you take Reglan, and the quantity of the dose you consume creates a higher concentration of Reglan in the brain. If you are under twenty, you are also in a higher risk category to develop tardive dyskinesia.7 The next time your doctor discusses Reglan for your condition, you should weigh the pros and cons of the medication with your doctor, and take the lowest dose for the shortest amount of time possible.
Is There a “Safer” Drug Alternative?
Sadly, there appears to be a safer “dopaminergic” antagonist that is in use in the European Union, domperidone.
In Europe, there is a much safer drug called domperidone but unlike Reglan, it does not cross the blood-brain barrier.8 Most of the CNS side effects are absent with domperidone meaning much less risk. Sadly, domperidone is not available in the United States because the intravenous form of has been linked to an irregular heartbeat.9
A safer prokinetic and anti-nausea agent would be to use fresh ginger, or New Chapter Ginger Force (as long as you have a healthy gallbladder).
The next medication I will write about is the most common prescribed medicine for “improving” digestive health, Proton Pump Inhibitors!
- http://www.drugs.com/monograph/metoclopramide-hydrochloride.html ↩
- http://www.drugbank.ca/drugs/DB01233 ↩
- Beers, Mark. The Merck Manual, Merck Research Laboratories, 2006 ↩
- Beers, Mark. The Merck Manual, Merck Research Laboratories, 2011 ↩
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1401167/ ↩
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1401167/ ↩
- https://goo.gl/XZJ9Kx ↩
- https://goo.gl/XZJ9Kx ↩
- http://www.ncbi.nlm.nih.gov/pubmed/20925438 ↩
Please help me. I was given Reglan IV push once only at my doctors office without knowing the side effects. She said it is safe. Perhaps the push was what made me feel the way I felt. Well after the administration of this drug I became extremely restless, anxious and felt like jumping out of my body. The next 10 days were horrific and most traumatic in my whole life. I went to ER and benadryl was administered there. I quickly discovered that what I am going through is a full blown internal akathisia. Some of the symptoms still linger and come back. I am at my wits end sometimes as these symptoms are at times unbearable. anxiety, depression, extreme fright and hyperactivity. Internal unrest. Muscle pain and rigidity, tendons feel tight and taut. I am trying to find a way to recover from this somehow. I guess it messed up my receptors or something. Please respond to my post. My doctor is useless. She doesn’t believe this could have happened due to one does of reglan.
Here I link a study in which one very important paragraph stands out: “The reason why anxiety symptoms actually emerged in this patient and why they persisted for several weeks after last exposure to metoclopramide is not fully clear. Apart from a conceivable vulnerability of the patient,the gastrointestinal infection being present in both cases when anxiety symptoms emerged, might be of importance. Gastroenteritis can lead to a secretion of cytokines as part of the immune response.15,16 Cytokines in turn have been suggested to be mediators of psychiatric conditions such as depression 17 or anxiety. 18 However, this hypothesis is highly speculative. While drug-induced symptoms mostly disappear after drug discontinuation, some can last markedly longer, such as tardive dyskinesias 19 or psychiatric symptoms…”
Full study here:
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1819.2007.01637.x/epdf
PS: I have SIBO and Giardia so intestinal inflammation is there. Now cytokine secretion must have created another problem but here I don’t know what to do.
It would appear to me that your sympathetic nervous system is in a state of over excitability. https://selfhacked.com/blog/28-ways-to-stimulate-your-vagus-nerve-and-all-you-need-to-know-about-it/ I would also try to reduce inflammation like making sure you are getting enough Omega 3 in your diet, taking magnesium supplementation, and getting sun whenever possible.
So what pro kinetics are good to take?
https://fixyourgut.com/sibo-methane-or-hydrogen-dominant-what-is-the-difference/