Taking Reglan for Your Migraine Could Give You a Bigger Headache


. By Gordon Gibb

Originally approved to treat Gastroesophageal Reflux Disease, Reglan it is often used off-label to treat severe headaches and migraines. While Reglan (metoclopramide) has proven effective to lessen the symptoms of headaches, patients need to be aware of Reglan side effects—not the least of which is tardive dyskinesia.

There is no question that severe headaches can be debilitating. While the exact etiology is unknown, there are various risk factors and associations at play, including a family history of migraine headaches (in the neighborhood of 70-80 percent), the use of certain medications, fatigue or emotional stress, exertion, and specific foods or alcohol, according to a recent Emedicine report from WebMD.

Depending on the type and severity of headache, various symptoms associated with migraines can be effectively treated with metoclopramide (Reglan). These include nausea (in 80% percent of the cases), vomiting (50%), yawning, irritability, hypotension and hyperactivity. Such symptoms are associated with dopamine receptor activation. Dopamine receptor hypersensitivity has been shown experimentally with dopamine agonists such as apomorphine, bromocriptine, and pergolide. Dopamine antagonists, such as metoclopramide (Reglan), have been shown clinically to treat migraine headaches effectively.

Patients, however, should be aware of Reglan side effects, especially tardive dyskinesia, a neurological disorder characterized by the involuntary movement of facial muscles (usually the tongue, lips and eyes) and, in rare cases, involuntary spastic movement of other limbs. The FDA required the addition of a black box warning to the label, advising patients and physicians of the heightened risk of tardive dyskinesia if used beyond 12 weeks.

However, tardive dyskinesia can occur at any time. Symptoms may cease when the medication is stopped, but for some, tardive dyskinesia is a lifelong affliction for which there is no known cure.


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