Doctors are being warned about the dangers of overprescribing a common anti-nausea drug that has been linked to permanent tremors and disability.
The treatment, metoclopramide, is prescribed to thousands of NHS patients each year to help cope with nausea and vomiting caused by chemotherapy, radiotherapy and conditions such as migraine and indigestion. It works by blocking the signals between the brain and gut that cause vomiting.
Following evidence that long-term use could cause neurological problems such as uncontrollable twitching and involuntary facial movements, regulators warned GPs in 2013 to only prescribe it for up to five days.
Research shows that patients taking metoclopramide may also develop depression. But experts say patients are still being given it for more than five days, putting them at risk of “lifelong” complications.
A woman is taking legal action after taking the drugs for 11 years and now has permanent problems with her vision, speech and movement.
Doctors are being warned about the dangers of overprescribing a common anti-nausea drug that has been linked to permanent tremors and disability.
The treatment, metoclopramide, is prescribed to thousands of NHS patients each year to help cope with nausea and vomiting caused by chemotherapy, radiotherapy and conditions such as migraine and indigestion.
Dr Tabish Saifee, from the National Hospital for Neurology and Neurosurgery, said: “The effects of these drugs can last a lifetime – they are socially and functionally disabling and difficult to treat.”
‘It is not that unusual that you see metoclopramide used for more than five days and very occasionally I see people on long-term treatments who have developed neurological problems. Sometimes they have not been followed up and simply continue taking the medications, but often they have conditions that are difficult to control.
‘Most of those who develop serious problems have been taking them for months or years. Specialists who prescribe them should be reminded of these risks. The best treatment is to prevent them from happening in the first place.”
Grandmother Petra Walker-Barrera started taking metoclopramide in 2008 to control nausea associated with her inflammatory bowel disease, ulcerative colitis, but says it left her life “in ruins.”
The 68-year-old woman returned to her GP in Dover several times to report symptoms including problems with her eyes and vision, inability to control jaw movement and weakness in her feet and legs. But her symptoms were repeatedly dismissed as anxiety and not drug-related.
“I had been back to the GP many times but all my symptoms were treated in isolation,” says Petra, who now lives in Stone, Staffordshire. “During one appointment, the GP told my daughter it was all in my head.”
Dr Tabish Saifee, from the National Hospital for Neurology and Neurosurgery (pictured), said: “The effects of these drugs can last a lifetime – they are socially and functionally disabling and difficult to treat.”
The 2013 warning from the Medicines and Healthcare products Regulatory Agency (MHRA) followed a review that concluded the risk of neurological problems outweighed the benefits of long-term treatment.
The updated advice said it should only be prescribed for a maximum of five days and should no longer be given for chronic conditions, including gastric problems and heartburn.
But despite this warning, five GPs reissued Petra’s prescription 30 times. It was not until 2019, when she had already been taking the medications for eight years, that experts at the National Hospital of Neurology and Neurosurgery recognized the link between her worsening symptoms and long-term medication use, which left her ” So angry”. and upset’.
Today she lives with movement disorders, tardive dystonia, and dyskinesia (conditions that research has directly linked to long-term use of the medication) and is confined to a wheelchair.
He has muscle weakness in his face which means he cannot smile, his speech is slurred and his problems walking have caused him numerous falls which have caused him to lose teeth. She has also had to fight for her life with sepsis and pneumonia because her eating and swallowing problems have led her to choke on food.
Following evidence that long-term use could cause neurological problems such as uncontrollable twitching and involuntary facial movements, regulators warned GPs in 2013 to only prescribe metoclopramide for up to five days.
Dr Philippa Kaye (pictured) said: ‘Due to the risk of serious side effects, metoclopramide should not be prescribed for more than five days.
“People need to know what metoclopramide can do,” Petra said.
‘Having spoken to patients across the country, I have heard that it is still prescribed long term. It is too easy to access repeat prescriptions and there are no checks by GPs. “We can’t let what happened to me happen to someone else – it’s ruining lives.”
The MHRA has received more than 2,800 reports of adverse reactions to the drug, the majority of them involving nervous system disorders.
Just under a quarter (631) have been reported since 2013, and suspected reactions have more than tripled since the early 2000s.
GP Dr Philippa Kaye said: “Due to the risk of serious side effects, metoclopramide should not be prescribed for more than five days. There will be cases where the benefits outweigh the risks, but all patients receiving prescriptions “They should regularly undergo an annual medication review to assess whether they are still appropriate.”
Petra is taking legal action against the five GPs who continued to prescribe her metoclopramide after 2013.
His solicitor Kelly Lloyd Davies, of Slater and Gordon, said: “This case raises serious questions about the process of issuing repeat prescriptions and ensuring that the patient’s wellbeing is not put at risk by failing to carry out appropriate medication reviews. “.
