Drug‐induced parkinsonism: A review of 17 years' experience in a regional pharmacovigilance center in France

Movement Disorders - Tập 26 Số 12 - Trang 2226-2231 - 2011
Emmanuelle Bondon‐Guitton1, Santiago Pérez-Lloret2,1, Haleh Bagheri1, Christine Brefel1, Olivier Rascol2,1, Jean‐Louis Montastruc1
1Laboratoire de Pharmacologie Médicale et Clinique, INSERM U 1027 Equipe de PharmacoEpidémiologie, Faculté de Médecine de l'Université de Toulouse, Toulouse and Service de Pharmacologie Clinique, Centre Midi-Pyrénées de PharmacoVigilance, de PharmacoEpidémiologie et d'Informations sur le Médicament, Centre Hospitalier Universitaire, Toulouse, France
2INSERM Centre d’Investigation Clinique CIC 9203, Toulouse, France

Tóm tắt

AbstractBesides antipsychotics, several drugs can induce parkinsonism. We review spontaneous notifications of drug‐induced or ‐worsened parkinsonism to a French regional pharmacovigilance center between 1993 and 2009. During these 17 years, 20,855 adverse drug reactions have been reported, including 155 (0.7%) cases of drug‐induced or ‐worsened parkinsonism. Most of the notifications have involved aged patients (48% between 60 and 79 years) and females (60%). “Seriousness” was found in 43.9% of cases. Worsening of parkinsonism occurred in 28 patients suffering from idiopathic Parkinson's disease. Sixty‐nine percent of drug‐induced or ‐worsened parkinsonism cases were observed during the first 3 months after introduction of the “suspect” drug (involving mainly central dopaminergic antagonists). A second peak (20%) was found 12 months after drug introduction (mainly caused by calcium channel blockers). The most frequently reported parkinsonian symptom was rigidity (78.7%). The three cardinal symptoms were found in 37.4% of notifications. Evolution was favorable (after partial or complete withdrawal of suspect drug[s]) in 88.7% of cases. Among the 261 suspect drugs, most involved central dopaminergic antagonists (49%), followed by antidepressants (8%), calcium channel blockers (5%), peripheral dopaminergic antagonists (5%), and H1 antihistamines (5%). Cases with lithium, valproic acid, amiodarone, anticholinesterases, or trimetazidine were also found. Three notifications were the result of pharmacokinetic interactions. We found that drug‐induced or ‐worsened parkinsonism is an often “serious,” but reversible, adverse drug reaction. It occurred more frequently between 60 and 79 years. Rigidity was the most frequently reported symptom. Approximately 50% of drug‐induced or ‐worsened parkinsonism cases spontaneously reported were related to drugs other than antipsychotics. Drug‐induced or ‐worsened parkinsonism can also be explained by pharmacokinetic drug interactions. © 2011 Movement Disorder Society

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Movement Disorders

Tập 26 Số 12

2226-2231

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