Reglan & Chemotherapy Side Effects

The effects of chemotherapy often make it difficult to absorb any kind of nourishment, as severe nausea is one of the primary side effects of chemotherapy drugs. One way to address this issue is to give patients additional medications that are used to relieve nausea associated with motion sickness and other causes. One such drug is metoclopramide, more commonly known by the brand name Reglan.

The Reglan Process

Metoclopramide was originally developed in the 1960s for use in mental hospitals in order to control symptoms of schizophrenia and other forms of psychosis. Like other common antipsychotic drugs (also known as neuroleptics), it is a dopamine antagonist or inhibitor. It works by preventing neuro-electrochemical receptors in the body from receiving signals from the brain.

Side Effects of Reglan

While Reglan worked well for short-term relief of nausea associated with chemotherapy, one-fifth of all patients experience side effects. One of these is fatigue, which is exacerbated by the effects of chemotherapy. On the other side, some patients experience extreme restlessness or agitation. In the most extreme cases, these can consist of compulsive movements of the arms and legs (primarily in children, adolescents and young adults under age 30).

Additional long-term problems result when a patient has been treated with Reglan for periods longer than three months. Clinical depression often results and others may develop twitches or movement disorders associated with Parkinson's disease as well as tardive dyskinesia. These symptoms are usually irreversible.

Who Should Avoid Reglan

Patients with a history of any of the following conditions should not receive treatment with Reglan:

Asthma
Clinical Depression
Kidney Disease
Hypertension
Parkinson's Disease (or similar symptoms)
Bleeding Ulcer

Reglan can also be passed through breast milk so nursing women should not take Reglan. Patients over the age of 55 have also been found to have an increased risk of hip fracture after taking Reglan.

Other Types of Antiemetics

An alternative class of antiemetics (anti-nausea medications) are known as serotonin receptor antagonists. This is a different type of neurotransmitter than dopamine as it regulates appetite and the vomiting reflex. Many types of antihistamines also help to control nausea as well as medical marijuana.

For patients who would prefer alternatives and avoid potential side effects, herbs such as peppermint and ginger have long been used to treat nausea. Hypnosis and acupuncture have also been reported as effective in this respect. However, any alternative treatments should be discussed with a doctor.

Sources

Associated Press. "Heartburn Drugs Tied to Hip-Fracture Risk." MSNBC News, http://www.msnbc.msn.com/id/16358462/ , 29 December 2006.
DeVault, K.R. and D.O. Castell. "Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease." American Journal of Gastroenterology, vol.94 no. 6 (1999).
Karlet, Mary and Linda Scheetz. Nurse Anesthesia Secrets. (Elsevier Health Sciences 2005).
Shaffer, Douglas et. al. "Tardive Dyskinesia and Metoclopramide Use: Effects of Cisapride Market Withdrawal." Journal of the American Pharmacists Association vol. 44 no. 6 (2004).

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