Atropinic (Anticholinergic) Burden in Parkinson's Disease.
Identifieur interne : 000150 ( PubMed/Corpus ); précédent : 000149; suivant : 000151Atropinic (Anticholinergic) Burden in Parkinson's Disease.
Auteurs : Sibylle De Germay ; Jean-Louis Montastruc ; Vanessa Rousseau ; Leila Chebane ; Emmanuelle Bondon-Guitton ; Florence Moulis ; Genevieve Durrieu ; Haleh Bagheri ; Olivier Rascol ; Antoine Pariente ; Bernard Bégaud ; François MontastrucSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2016.
Abstract
Use of atropinic drugs remains controversial in Parkinson's disease (PD) because there is insufficient evidence about their efficacy and they can induce serious adverse drug reactions. Atropinic risk scales were developed to help to identify atropinic drugs in prescription forms and to evaluate their burden in clinical practice. In the present review, we discuss the few studies investigating atropinic burden in PD and present the results of our study indicating that atropinic drugs are still widely prescribed in PD (almost 3 of 5 prescriptions) with a clinically significant atropinic burden in around 1 of 6 PD patients. Drugs mainly responsible for high values of atropinic burden were those used for nonmotor symptoms. Clinically significant atropinic burdens were mainly induced by associations of several "low-risk" drugs. Physicians must be aware that in addition to classical atropinic antiparkinsonian drugs, many others (psychotropics) can contribute to increased atropinic burden in PD patients. © 2016 International Parkinson and Movement Disorder Society.
DOI: 10.1002/mds.26595
PubMed: 27028036
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Francois" uniqKey="Montastruc F" first="François" last="Montastruc">François Montastruc</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27028036</idno><idno type="pmid">27028036</idno><idno type="doi">10.1002/mds.26595</idno><idno type="wicri:Area/PubMed/Corpus">000150</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000150</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Atropinic (Anticholinergic) Burden in Parkinson's Disease.</title><author><name sortKey="De Germay, Sibylle" sort="De Germay, Sibylle" uniqKey="De Germay S" first="Sibylle" last="De Germay">Sibylle De Germay</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Rousseau, Vanessa" sort="Rousseau, Vanessa" uniqKey="Rousseau V" first="Vanessa" last="Rousseau">Vanessa Rousseau</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Chebane, Leila" sort="Chebane, Leila" uniqKey="Chebane L" first="Leila" last="Chebane">Leila Chebane</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><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>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Moulis, Florence" sort="Moulis, Florence" uniqKey="Moulis F" first="Florence" last="Moulis">Florence Moulis</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Durrieu, Genevieve" sort="Durrieu, Genevieve" uniqKey="Durrieu G" first="Genevieve" last="Durrieu">Genevieve Durrieu</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Bagheri, Haleh" sort="Bagheri, Haleh" uniqKey="Bagheri H" first="Haleh" last="Bagheri">Haleh Bagheri</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pariente, Antoine" sort="Pariente, Antoine" uniqKey="Pariente A" first="Antoine" last="Pariente">Antoine Pariente</name><affiliation><nlm:affiliation>Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</nlm:affiliation></affiliation></author><author><name sortKey="Begaud, Bernard" sort="Begaud, Bernard" uniqKey="Begaud B" first="Bernard" last="Bégaud">Bernard Bégaud</name><affiliation><nlm:affiliation>Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</nlm:affiliation></affiliation></author><author><name sortKey="Montastruc, Francois" sort="Montastruc, Francois" uniqKey="Montastruc F" first="François" last="Montastruc">François Montastruc</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Use of atropinic drugs remains controversial in Parkinson's disease (PD) because there is insufficient evidence about their efficacy and they can induce serious adverse drug reactions. Atropinic risk scales were developed to help to identify atropinic drugs in prescription forms and to evaluate their burden in clinical practice. In the present review, we discuss the few studies investigating atropinic burden in PD and present the results of our study indicating that atropinic drugs are still widely prescribed in PD (almost 3 of 5 prescriptions) with a clinically significant atropinic burden in around 1 of 6 PD patients. Drugs mainly responsible for high values of atropinic burden were those used for nonmotor symptoms. Clinically significant atropinic burdens were mainly induced by associations of several "low-risk" drugs. Physicians must be aware that in addition to classical atropinic antiparkinsonian drugs, many others (psychotropics) can contribute to increased atropinic burden in PD patients. © 2016 International Parkinson and Movement Disorder Society.</div></front></TEI><pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">27028036</PMID><DateCreated><Year>2016</Year><Month>05</Month><Day>09</Day></DateCreated><DateRevised><Year>2016</Year><Month>05</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>31</Volume><Issue>5</Issue><PubDate><Year>2016</Year><Month>May</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Atropinic (Anticholinergic) Burden in Parkinson's Disease.</ArticleTitle><Pagination><MedlinePgn>632-6</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.26595</ELocationID><Abstract><AbstractText>Use of atropinic drugs remains controversial in Parkinson's disease (PD) because there is insufficient evidence about their efficacy and they can induce serious adverse drug reactions. Atropinic risk scales were developed to help to identify atropinic drugs in prescription forms and to evaluate their burden in clinical practice. In the present review, we discuss the few studies investigating atropinic burden in PD and present the results of our study indicating that atropinic drugs are still widely prescribed in PD (almost 3 of 5 prescriptions) with a clinically significant atropinic burden in around 1 of 6 PD patients. Drugs mainly responsible for high values of atropinic burden were those used for nonmotor symptoms. Clinically significant atropinic burdens were mainly induced by associations of several "low-risk" drugs. Physicians must be aware that in addition to classical atropinic antiparkinsonian drugs, many others (psychotropics) can contribute to increased atropinic burden in PD patients. © 2016 International Parkinson and Movement Disorder Society.</AbstractText><CopyrightInformation>© 2016 International Parkinson and Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>De Germay</LastName><ForeName>Sibylle</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Montastruc</LastName><ForeName>Jean-Louis</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC INSERM 1436, Université et Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>NeuroToul Centre of Excellence in Neurodegeneration, Université et Centre Hospitalier Universitaire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rousseau</LastName><ForeName>Vanessa</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC INSERM 1436, Université et Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chebane</LastName><ForeName>Leila</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bondon-Guitton</LastName><ForeName>Emmanuelle</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moulis</LastName><ForeName>Florence</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Durrieu</LastName><ForeName>Genevieve</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bagheri</LastName><ForeName>Haleh</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>NeuroToul Centre of Excellence in Neurodegeneration, Université et Centre Hospitalier Universitaire, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rascol</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC INSERM 1436, Université et Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>NeuroToul Centre of Excellence in Neurodegeneration, Université et Centre Hospitalier Universitaire, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 825, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pariente</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM U 657, Pharmacoepidemiology, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bégaud</LastName><ForeName>Bernard</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM U 657, Pharmacoepidemiology, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Montastruc</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIC INSERM 1436, Université et Centre Hospitalier Universitaire de Toulouse, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>NeuroToul Centre of Excellence in Neurodegeneration, Université et Centre Hospitalier Universitaire, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>03</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Parkinson's disease</Keyword><Keyword MajorTopicYN="N">anticholinergic burden</Keyword><Keyword MajorTopicYN="N">anticholinergic drugs</Keyword><Keyword MajorTopicYN="N">atropinic 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