-STL Today

09/17/2009 -Q. A dear friend was put on Reglan for acid stomach and left on the drug for nine years. The therapy is only supposed to last a few weeks.

She now has tardive dyskinesia. Her tongue is enlarged, and she can no longer speak properly. The side effects did not go away when the drug was stopped. Is there anything that can help her? Please warn your readers about Reglan.

A. Reglan (metoclopramide) was first approved for use in the U.S. in 1980. It is prescribed for digestive-tract problems such as reflux, delayed stomach emptying and nausea. Although doctors were warned early on that this drug could cause a neurological disorder, it took the Food and Drug Administration almost 40 years to issue a black-box warning about this complication.

On Feb. 26, the agency cautioned about metoclopramide: "Tardive dyskinesia is characterized by involuntary, repetitive movements of the extremities, or lip smacking, grimacing, tongue protrusion, rapid eye movements or blinking, puckering and pursing of the lips, or impaired movement of the fingers. These symptoms are rarely reversible and there is no known treatment. However, in some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped."