Reglan - Treatment for Radiation Therapy Side Effects

Cancer patients who undergo radiation treatments often experience nausea. Controlling these symptoms is vitally important because proper nutrition is important for the recovery process of cancer patients. It is one reason why oncologist's and other doctors involved in cancer treatment have prescribed metoclopramide, which is commonly sold under the brand name Reglan.

The Uses of Metoclopramide

First developed in the 1960s as an antipsychotic or neuroleptic medication to treat schizophrenics, metoclopramide works by shutting down the dopamine receptors in the body, which receive neurochemical instructions from the brain. In order for an antipsychotic medication to work properly, it must be able to cross the "blood-brain barrier," a fine network of capillaries that screen out certain chemicals from the blood and prevent them from entering the brain tissue itself.

Unlike more established and commonly-used medications (namely chloropromazine and haloperidol), metoclopramide was not able to cross this barrier. However, when it came to gastrointestinal problems, this was not an issue since the control center of this system lies outside of the brain. This made metoclopramide an excellent treatment for motion sickness and other forms of nausea.

Side Effects of Metoclopramide

Although effective for short-term relief of symptoms, it has been found that one in five patients will experience immediate side effects from metoclopramide (Reglan). Among radiation patients, Reglan may cause feelings of fatigue that have already resulted from the treatment. Some patients may have feelings of restlessness or agitation. People under the age of 30 may find it impossible to control movements of the extremities.

Long-term (90 days or more) effects include clinical depression and movement disorders such as tardive dyskinesia or ones similar to patients with Parkinson's disease. Most at risk for these symptoms, which are usually permanent, are women over the age of 55.

Asthmatics and those already diagnosed with clinical depression should not take Reglan. It should also be avoided by those with kidney disorders, Parkinson's disease or any kind of ulcer or gastrointestinal bleeding. Patients being treated for high blood pressure should also avoid Reglan.

Although it has not been established as to whether Reglan can pass the placental barrier and affect a fetus, the medication can be transferred to a child through breastfeeding. For this reason, nursing women should avoid taking Reglan. A study published in 2004 also established an increased risk of hip fracture among elderly patients treated with Reglan.

Alternative Medications

Serotonin is another type of neurotransmitter that is specific to the regulation of digestive function. Serotonin blockers are thus a good alternative to dopamine receptor antagonists Reglan. Medical marijuana has also been established as an effective remedy for relieving nausea and stimulating appetite among cancer patients. Herbal and other non-chemical treatments include peppermint and ginger as well as hypnotherapy and acupuncture. Regardless of the alternative, cancer patients should discuss any such choices with their doctor before undergoing such treatments.

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).