Neurologic approach to drug-induced movement disorders: a study of 125 patients.
Identifieur interne : 002028 ( Main/Merge ); précédent : 002027; suivant : 002029Neurologic approach to drug-induced movement disorders: a study of 125 patients.
Auteurs : L Miller ; Joseph Jankovic [États-Unis]Source :
- Southern medical journal [ 0038-4348 ] ; 1990.
English descriptors
- KwdEn :
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Amitriptyline (adverse effects), Antipsychotic Agents (adverse effects), Chorea (chemically induced), Chorea (diagnosis), Dyskinesia, Drug-Induced (classification), Dyskinesia, Drug-Induced (diagnosis), Dystonia (chemically induced), Dystonia (diagnosis), Female, Haloperidol (adverse effects), Humans, Male, Mental Disorders (drug therapy), Middle Aged, Parkinson Disease, Secondary (chemically induced), Parkinson Disease, Secondary (diagnosis), Perphenazine (adverse effects), Psychomotor Agitation, Sex Factors, Tremor (chemically induced), Tremor (diagnosis).
- MESH :
- chemical , adverse effects : Amitriptyline, Antipsychotic Agents, Haloperidol, Perphenazine.
- chemically induced : Chorea, Dystonia, Parkinson Disease, Secondary, Tremor.
- classification : Dyskinesia, Drug-Induced.
- diagnosis : Chorea, Dyskinesia, Drug-Induced, Dystonia, Parkinson Disease, Secondary, Tremor.
- drug therapy : Mental Disorders.
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Psychomotor Agitation, Sex Factors.
Abstract
Of 125 patients with neuroleptic (dopamine blocking) drug-induced movement disorders who had been referred to a specialized clinic to differentiate the predominant movement disorder, 63% had tardive dyskinesia, 30% had parkinsonism, 24% had dystonia, 7% had akathisia, and 2% had isolated tremor. Two or more movement disorders coexisted in 31 patients (25%). Functional disability was more severe in patients with akathisia than in other patients. Women outnumbered men at a ratio of 4:1, except for tardive dystonia which affected both sexes equally. The average at onset was 56 years (range, 13 to 87); 69 patients (55%) had onset of movement disorder in the sixth decade. While tardive dystonia was distributed relatively evenly in all age groups, almost a third of patients with parkinsonism had it in the eighth decade. Haloperidol was implicated in 47 patients (37%), followed by amitriptyline/perphenazine in 30%, thioridazine in 27%, and chlorpromazine in 20%. Metoclopramide-induced movement disorders were found in 10 (8%). Most patients (101 or 81%) had history of psychiatric illnesses, but of these only 44 had psychosis. Neuroleptic drugs had been prescribed for 33 patients (26%) who had gastrointestinal problems. It is important to recognize and differentiate various drug-induced movement disorders because such differentiation has pathophysiologic and therapeutic implications. Many patients could have been treated with less potent drugs.
PubMed: 1971459
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pubmed:1971459Le document en format XML
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<author><name sortKey="Miller, L G" sort="Miller, L G" uniqKey="Miller L" first="L" last="Miller">L Miller</name>
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">Joseph Jankovic</name>
<affiliation><country>États-Unis</country>
<placeName><settlement type="city">Houston</settlement>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Neurologic approach to drug-induced movement disorders: a study of 125 patients.</title>
<author><name sortKey="Miller, L G" sort="Miller, L G" uniqKey="Miller L" first="L" last="Miller">L Miller</name>
<affiliation><nlm:affiliation>Department of Family Medicine, Baylor College of Medicine, Houston, Tex.</nlm:affiliation>
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">Joseph Jankovic</name>
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<series><title level="j">Southern medical journal</title>
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<imprint><date when="1990" type="published">1990</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Amitriptyline (adverse effects)</term>
<term>Antipsychotic Agents (adverse effects)</term>
<term>Chorea (chemically induced)</term>
<term>Chorea (diagnosis)</term>
<term>Dyskinesia, Drug-Induced (classification)</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Dystonia (chemically induced)</term>
<term>Dystonia (diagnosis)</term>
<term>Female</term>
<term>Haloperidol (adverse effects)</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Disorders (drug therapy)</term>
<term>Middle Aged</term>
<term>Parkinson Disease, Secondary (chemically induced)</term>
<term>Parkinson Disease, Secondary (diagnosis)</term>
<term>Perphenazine (adverse effects)</term>
<term>Psychomotor Agitation</term>
<term>Sex Factors</term>
<term>Tremor (chemically induced)</term>
<term>Tremor (diagnosis)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Amitriptyline</term>
<term>Antipsychotic Agents</term>
<term>Haloperidol</term>
<term>Perphenazine</term>
</keywords>
<keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Chorea</term>
<term>Dystonia</term>
<term>Parkinson Disease, Secondary</term>
<term>Tremor</term>
</keywords>
<keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Dyskinesia, Drug-Induced</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Chorea</term>
<term>Dyskinesia, Drug-Induced</term>
<term>Dystonia</term>
<term>Parkinson Disease, Secondary</term>
<term>Tremor</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Mental Disorders</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Age Factors</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Psychomotor Agitation</term>
<term>Sex Factors</term>
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<front><div type="abstract" xml:lang="en">Of 125 patients with neuroleptic (dopamine blocking) drug-induced movement disorders who had been referred to a specialized clinic to differentiate the predominant movement disorder, 63% had tardive dyskinesia, 30% had parkinsonism, 24% had dystonia, 7% had akathisia, and 2% had isolated tremor. Two or more movement disorders coexisted in 31 patients (25%). Functional disability was more severe in patients with akathisia than in other patients. Women outnumbered men at a ratio of 4:1, except for tardive dystonia which affected both sexes equally. The average at onset was 56 years (range, 13 to 87); 69 patients (55%) had onset of movement disorder in the sixth decade. While tardive dystonia was distributed relatively evenly in all age groups, almost a third of patients with parkinsonism had it in the eighth decade. Haloperidol was implicated in 47 patients (37%), followed by amitriptyline/perphenazine in 30%, thioridazine in 27%, and chlorpromazine in 20%. Metoclopramide-induced movement disorders were found in 10 (8%). Most patients (101 or 81%) had history of psychiatric illnesses, but of these only 44 had psychosis. Neuroleptic drugs had been prescribed for 33 patients (26%) who had gastrointestinal problems. It is important to recognize and differentiate various drug-induced movement disorders because such differentiation has pathophysiologic and therapeutic implications. Many patients could have been treated with less potent drugs.</div>
</front>
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