Drug-induced parkinsonism: a review of 17 years' experience in a regional pharmacovigilance center in France.
Identifieur interne : 001121 ( PubMed/Corpus ); précédent : 001120; suivant : 001122Drug-induced parkinsonism: a review of 17 years' experience in a regional pharmacovigilance center in France.
Auteurs : Emmanuelle Bondon-Guitton ; Santiago Perez-Lloret ; Haleh Bagheri ; Christine Brefel ; Olivier Rascol ; Jean-Louis MontastrucSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2011.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Antipsychotic Agents.
- geographic : France.
- chemically induced : Parkinson Disease, Secondary.
- Age Factors, Female, Humans, Longitudinal Studies, Male, Pharmacovigilance, Retrospective Studies, Time Factors.
Abstract
Besides 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.
DOI: 10.1002/mds.23828
PubMed: 21674626
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pubmed:21674626Le document en format XML
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<author><name sortKey="Bondon Guitton, Emmanuelle" sort="Bondon Guitton, Emmanuelle" uniqKey="Bondon Guitton E" first="Emmanuelle" last="Bondon-Guitton">Emmanuelle Bondon-Guitton</name>
<affiliation><nlm:affiliation>Laboratoire 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. guitton@cict.fr</nlm:affiliation>
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<author><name sortKey="Perez Lloret, Santiago" sort="Perez Lloret, Santiago" uniqKey="Perez Lloret S" first="Santiago" last="Perez-Lloret">Santiago Perez-Lloret</name>
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<author><name sortKey="Bagheri, Haleh" sort="Bagheri, Haleh" uniqKey="Bagheri H" first="Haleh" last="Bagheri">Haleh Bagheri</name>
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<author><name sortKey="Brefel, Christine" sort="Brefel, Christine" uniqKey="Brefel C" first="Christine" last="Brefel">Christine Brefel</name>
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<author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name>
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<front><div type="abstract" xml:lang="en">Besides 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.</div>
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