[Drug-induced parkinsonian syndromes: a 10-year experience at a regional center of pharmaco-vigilance].
Identifieur interne : 004912 ( Main/Curation ); précédent : 004911; suivant : 004913[Drug-induced parkinsonian syndromes: a 10-year experience at a regional center of pharmaco-vigilance].
Auteurs : M E Llau [France] ; L. Nguyen ; J M Senard ; O. Rascol ; J L MontastrucSource :
- Revue neurologique [ 0035-3787 ] ; 1994.
Descripteurs français
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Adult, Adverse Drug Reaction Reporting Systems, Aged, Aged, 80 and over, Aging, Antipsychotic Agents (adverse effects), Calcium Channel Blockers (adverse effects), Dopamine Antagonists (adverse effects), Drug Interactions, Female, France, Humans, Male, Middle Aged, Parkinson Disease, Secondary (chemically induced), Retrospective Studies.
- MESH :
- chemical , adverse effects : Antipsychotic Agents, Calcium Channel Blockers, Dopamine Antagonists.
- geographic : France.
- chemically induced : Parkinson Disease, Secondary.
- Adult, Adverse Drug Reaction Reporting Systems, Aged, Aged, 80 and over, Aging, Drug Interactions, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
Besides classical neuroleptics, several drugs can induce parkinsonian symptoms. The present retrospective study investigates the characteristics of drug-induced parkinsonism notified to the Midi-Pyrénées Pharmacovigilance Centre between 1983 and 1992. Among 3,923 side effects spontaneously reported between 1983 and 1992 to the center, 53 (1.4%) were drug-induced parkinsonism. Mean age was 65 +/- 2 (s.e.m.) years (range 21-88). Drug-induced parkinsonism appeared after a mean treatment duration of 473 +/- 142 days (range 1 day to 15 years) and occurred most frequently in women (63%). The occurrence onset of drug-induced Parkinsonism exhibited a bimodal pattern with a first peak (between 0 and 6 months) mainly due to peripheral or central antidopaminergic drugs and a second one later (between 9 and 12 months) due mostly to calcium channel blockers. Involved drugs were mostly antidopaminergic agents: neuroleptics (antipsychotic drugs: 39%) but also agents used for nausea or vomiting (domperidone, metoclopramide, metopimazine or triethylperazine: 12%) or symptoms associated with menopause (veralipride: 6%). Other cases were related mainly to drugs with "calcium channel blocker" properties (flunarizine and cinnarizine: 30%), H1 antihistamine (1 case), fluoxetine (1 case), alphamethyldopa (1 case) or reserpine (1 case) whereas 3 cases were due to drug interactions. Imputability scores (according to the method of assessment of unexpected drug reactions used in France) were "doubtful" (11%), "plausible" (34%) and "probable" (53%). The complete triad (tremor, akinesia plus rigidity) was seen in 13 (25%) cases. Symmetrical symptoms occurred in 41 (77%) patients. A total disappearance of the clinical feature occurred in 39 (74%) patients whereas in 8 cases (15%), drug-induced parkinsonism led to the diagnosis of underlying idiopathic Parkinson's disease. The present study shows that around 80% of drug-induced parkinsonism are due to two pharmacological classes: central and peripheral antidopaminergic agents and calcium channel blockers.
PubMed: 7597368
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Nguyen</name></author><author><name sortKey="Senard, J M" sort="Senard, J M" uniqKey="Senard J" first="J M" last="Senard">J M Senard</name></author><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name></author><author><name sortKey="Montastruc, J L" sort="Montastruc, J L" uniqKey="Montastruc J" first="J L" last="Montastruc">J L Montastruc</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1994">1994</date><idno type="RBID">pubmed:7597368</idno><idno type="pmid">7597368</idno><idno type="wicri:Area/PubMed/Corpus">001658</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001658</idno><idno type="wicri:Area/PubMed/Curation">001617</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001617</idno><idno type="wicri:Area/PubMed/Checkpoint">001617</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001617</idno><idno type="wicri:Area/Ncbi/Merge">001C59</idno><idno type="wicri:Area/Ncbi/Curation">001C59</idno><idno type="wicri:Area/Ncbi/Checkpoint">001C59</idno><idno type="wicri:doubleKey">0035-3787:1994:Llau M:drug:induced:parkinsonian</idno><idno type="wicri:Area/Main/Merge">005237</idno><idno type="wicri:Area/Main/Curation">004912</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Drug-induced parkinsonian syndromes: a 10-year experience at a regional center of pharmaco-vigilance].</title><author><name sortKey="Llau, M E" sort="Llau, M E" uniqKey="Llau M" first="M E" last="Llau">M E Llau</name><affiliation wicri:level="3"><nlm:affiliation>Service de Pharmacologie Clinique, Centre Hospitalier Universitaire, Faculté de Médicine, Toulouse.</nlm:affiliation><country>France</country><placeName><settlement type="city">Toulouse</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Midi-Pyrénées</region></placeName><wicri:orgArea>Service de Pharmacologie Clinique, Centre Hospitalier Universitaire, Faculté de Médicine</wicri:orgArea></affiliation></author><author><name sortKey="Nguyen, L" sort="Nguyen, L" uniqKey="Nguyen L" first="L" last="Nguyen">L. Nguyen</name></author><author><name sortKey="Senard, J M" sort="Senard, J M" uniqKey="Senard J" first="J M" last="Senard">J M Senard</name></author><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name></author><author><name sortKey="Montastruc, J L" sort="Montastruc, J L" uniqKey="Montastruc J" first="J L" last="Montastruc">J L Montastruc</name></author></analytic><series><title level="j">Revue neurologique</title><idno type="ISSN">0035-3787</idno><imprint><date when="1994" type="published">1994</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Adverse Drug Reaction Reporting Systems</term><term>Aged</term><term>Aged, 80 and over</term><term>Aging</term><term>Antipsychotic Agents (adverse effects)</term><term>Calcium Channel Blockers (adverse effects)</term><term>Dopamine Antagonists (adverse effects)</term><term>Drug Interactions</term><term>Female</term><term>France</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease, Secondary (chemically induced)</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antipsychotic Agents</term><term>Calcium Channel Blockers</term><term>Dopamine Antagonists</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>France</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Parkinson Disease, Secondary</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Adverse Drug Reaction Reporting Systems</term><term>Aged</term><term>Aged, 80 and over</term><term>Aging</term><term>Drug Interactions</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Besides classical neuroleptics, several drugs can induce parkinsonian symptoms. The present retrospective study investigates the characteristics of drug-induced parkinsonism notified to the Midi-Pyrénées Pharmacovigilance Centre between 1983 and 1992. Among 3,923 side effects spontaneously reported between 1983 and 1992 to the center, 53 (1.4%) were drug-induced parkinsonism. Mean age was 65 +/- 2 (s.e.m.) years (range 21-88). Drug-induced parkinsonism appeared after a mean treatment duration of 473 +/- 142 days (range 1 day to 15 years) and occurred most frequently in women (63%). The occurrence onset of drug-induced Parkinsonism exhibited a bimodal pattern with a first peak (between 0 and 6 months) mainly due to peripheral or central antidopaminergic drugs and a second one later (between 9 and 12 months) due mostly to calcium channel blockers. Involved drugs were mostly antidopaminergic agents: neuroleptics (antipsychotic drugs: 39%) but also agents used for nausea or vomiting (domperidone, metoclopramide, metopimazine or triethylperazine: 12%) or symptoms associated with menopause (veralipride: 6%). Other cases were related mainly to drugs with "calcium channel blocker" properties (flunarizine and cinnarizine: 30%), H1 antihistamine (1 case), fluoxetine (1 case), alphamethyldopa (1 case) or reserpine (1 case) whereas 3 cases were due to drug interactions. Imputability scores (according to the method of assessment of unexpected drug reactions used in France) were "doubtful" (11%), "plausible" (34%) and "probable" (53%). The complete triad (tremor, akinesia plus rigidity) was seen in 13 (25%) cases. Symmetrical symptoms occurred in 41 (77%) patients. A total disappearance of the clinical feature occurred in 39 (74%) patients whereas in 8 cases (15%), drug-induced parkinsonism led to the diagnosis of underlying idiopathic Parkinson's disease. The present study shows that around 80% of drug-induced parkinsonism are due to two pharmacological classes: central and peripheral antidopaminergic agents and calcium channel blockers.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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