Reglan - Why So Long?
One of the issues that is sure to be a central part of Reglan defenses is the matter of why doctors ignore the advice to prescribe the medication only for short periods — 3 months — at a time, and instead prescribe it for longer, off-label uses. The development of Tardive Dyskinesia is known to be linked in part to the length of exposure to Reglan, so why are doctors still prescribing it for longer periods in approximately 20 percent of cases?
The answer lies in a more complete understanding of the illness that Reglan treats, GERD. This condition, also known as Acid Reflux Disease, is a condition in which the stomach produces an excess of gastric acids. These acids climb up into the throat and sear the lining of the esophagus. Sear is the correct word here — stomach acid is some of the strongest naturally-occurring acid in the world. Even brief exposure is uncomfortable, and extended exposure is actively painful. It has been known to rob people of sleep, exhausting them. Furthermore, it can so damage the esophagus that it might have a link to the formation of throat cancer over the long term. It is not a condition that can be covered up, suffered through or ignored.
On a related note, the alternatives to taking Reglan aren't automatically better. Proton pump inhibitors such as Prilosec, Aciphex and Nexium do help the situation by reducing the amount of acid the stomach produces. However, these medicines decline in effectiveness over time in many cases. In others, they have been known to lead to compromises in the immune system when taken for extended periods. Frequently they can only be taken in 14-day cycles, with 4-month intervals recommended between bouts. GERD often resurges in these interludes, leaving the patient with few options. Even more discouraging, proton pump inhibitors have been tentatively linked with hip fractures in elderly patients.
Thus it becomes clear that the question, “well, why did they take it so long?,” is one that entirely misses the point of the condition the patient was dealing with.
---
