Warning because long-term use of an anti-nausea pill is linked to depression and muscle weakness

Doctors are being warned about the dangers of overprescribing a common disease drug that has been linked to permanent tremors and disability.

The treatment, metoclopramide, is prescribed to thousands of NHS patients every year to help deal with nausea and vomiting caused by chemotherapy, radiotherapy and conditions such as migraines and indigestion. It works by blocking signals between the brain and the intestines that cause vomiting.

After evidence that long-term use could cause neurological problems such as uncontrollable spasms and involuntary facial movements, regulators warned GPs in 2013 against prescribing the drug for only up to five days.

Research shows that patients taking metoclopramide can also develop depression. But experts say patients are still getting it for more than five days, putting them at risk of ‘lifelong’ complications.

One woman is taking legal action after taking the drugs for more than 11 years and now having permanent problems with her vision, speech and movement.

The treatment, metoclopramide, is prescribed to thousands of NHS patients every year to help deal with nausea and vomiting caused by chemotherapy, radiotherapy and conditions such as migraines and indigestion.

Dr. Tabish Saifee, from the National Hospital for Neurology and Neurosurgery, said: ‘The effects of these drugs are potentially lifelong – they are socially and functionally debilitating and difficult to treat.

‘It’s not that rare to see metoclopramide used for more than five days, and very occasionally I see people on long-term treatment who have developed neurological problems. Sometimes they are not followed and continue to take the medication, but often they have conditions that are difficult to control.

‘The majority who develop serious problems have been using 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 the nausea associated with her inflammatory bowel disease ulcerative colitis, but says it left her life “in shambles.”

The 68-year-old returned to her GP in Dover several times to report symptoms including problems with her eyes and vision, an inability to control the movement of her jaw and weakness in her feet and legs. But her symptoms were repeatedly dismissed as anxiety and not drug-related.

‘I had gone back to the GP so 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 that 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 potentially be lifelong – they are socially and functionally debilitating and difficult to treat.

The 2013 warning from the Medicines and Healthcare products Regulatory Agency (MHRA) came after a study found that the risk of neurological problems outweighed the benefits of long-term treatment.

The updated advice said it should only be prescribed for up to five days and should no longer be given for chronic conditions including stomach problems and heartburn.

But despite this warning, five GPs reissued Petra’s prescription thirty times. It wasn’t until 2019, when she had been taking the drugs for eight years, that the link between her worsening symptoms and long-term medication use was recognized by experts at the National Hospital for Neurology and Neurosurgery, which “made her so angry.” and angry’.

Today, she suffers from 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.

She has muscle weakness in her face which means she cannot smile, her speech is slurred and her problems walking have led to numerous falls, causing her to lose teeth. She also has to fight for her life with sepsis and pneumonia as problems with eating and swallowing have led to her choking on her food.

Following evidence that long-term use could cause neurological problems such as uncontrollable spasms and involuntary facial movements, regulators warned GPs in 2013 to only prescribe metoclopramide for up to five days

GP 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.

‘After speaking to patients across the country, I have heard that it is still prescribed long-term. It is too easy to obtain repeat prescriptions and checks by general practitioners are not carried out. We cannot allow what happened to me to happen to anyone else; it ruins lives.”

The MHRA has received more than 2,800 reports of side effects from the drug, most of which relate to nervous system disorders.

Just under a quarter (631) have been reported since 2013, with suspected reactions having 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 with a regular prescription should have an annual medication review to assess whether they are still appropriate.”

Petra is taking legal action against the five general practitioners who continued to prescribe her metoclopramide after 2013.

Her lawyer Kelly Lloyd Davies, of Slater and Gordon, said: ‘This case raises serious questions about the process of issuing repeat prescriptions, and ensuring that patient welfare is not compromised by a failure to carry out appropriate medication reviews to be carried out.’