Drug-induced parkinsonism: diagnosis and treatment.

IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY Expert Opinion on Drug Safety Pub Date : 2024-10-25 DOI:10.1080/14740338.2024.2418950
Hannah Conn, Joseph Jankovic
{"title":"Drug-induced parkinsonism: diagnosis and treatment.","authors":"Hannah Conn, Joseph Jankovic","doi":"10.1080/14740338.2024.2418950","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Drug-induced parkinsonism (DIP) is one of the most common iatrogenic movement disorders. It is characterized by tremors, slowness of movement, and shuffling gait with postural instability, clinically indistinguishable from idiopathic Parkinson's disease. Prior exposure to antipsychotic medications or other dopamine receptor blocking agents (DRBAs) is required for the diagnosis.</p><p><strong>Areas covered: </strong>This article aims to review the epidemiology, pathophysiology, clinical features, ancillary testing, and treatment of DIP. A literature search was undertaken in PubMed from January 2013 to January 2024.</p><p><strong>Expert opinion: </strong>A clinician's suspicion of DIP must always be present when a patient develops acute to subacute onset of parkinsonism while taking a DRBA. As DIP can be indistinguishable from idiopathic PD, ancillary testing, such as DaTscans and skin biopsy searching for alpha-synuclein deposits, are often required to make a definitive diagnosis. When DIP develops, steps should be taken to discontinue the offending agent or, in the case of antipsychotics, dose reduction or change to an agent with lower risk for DIP, such as quetiapine or clozapine. Prophylactic treatment with anticholinergics is not indicated.</p>","PeriodicalId":12232,"journal":{"name":"Expert Opinion on Drug Safety","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Opinion on Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14740338.2024.2418950","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Drug-induced parkinsonism (DIP) is one of the most common iatrogenic movement disorders. It is characterized by tremors, slowness of movement, and shuffling gait with postural instability, clinically indistinguishable from idiopathic Parkinson's disease. Prior exposure to antipsychotic medications or other dopamine receptor blocking agents (DRBAs) is required for the diagnosis.

Areas covered: This article aims to review the epidemiology, pathophysiology, clinical features, ancillary testing, and treatment of DIP. A literature search was undertaken in PubMed from January 2013 to January 2024.

Expert opinion: A clinician's suspicion of DIP must always be present when a patient develops acute to subacute onset of parkinsonism while taking a DRBA. As DIP can be indistinguishable from idiopathic PD, ancillary testing, such as DaTscans and skin biopsy searching for alpha-synuclein deposits, are often required to make a definitive diagnosis. When DIP develops, steps should be taken to discontinue the offending agent or, in the case of antipsychotics, dose reduction or change to an agent with lower risk for DIP, such as quetiapine or clozapine. Prophylactic treatment with anticholinergics is not indicated.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
药物引起的帕金森病:诊断和治疗。
简介药物诱发帕金森病(DIP)是最常见的先天性运动障碍之一。其特点是震颤、行动迟缓、步态不稳,临床上与特发性帕金森病无异。确诊时需要先服用抗精神病药物或其他多巴胺受体阻断剂(DRBAs):本文旨在回顾 DIP 的流行病学、病理生理学、临床特征、辅助检查和治疗。在PubMed上搜索了2013年1月至2024年1月的文献:当患者在服用 DRBA 时出现急性或亚急性帕金森病发作时,临床医生必须始终怀疑 DIP 的存在。由于 DIP 可能与特发性帕金森病难以区分,因此通常需要进行辅助检查,如 DaTscans 和皮肤活检,以寻找α-突触核蛋白沉积物,从而做出明确诊断。当出现 DIP 时,应采取措施停用违规药物,如果是抗精神病药物,则应减少剂量或改用 DIP 风险较低的药物,如喹硫平或氯氮平。无需使用抗胆碱能药物进行预防性治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.90
自引率
3.20%
发文量
97
审稿时长
6-12 weeks
期刊介绍: Expert Opinion on Drug Safety ranks #62 of 216 in the Pharmacology & Pharmacy category in the 2008 ISI Journal Citation Reports. Expert Opinion on Drug Safety (ISSN 1474-0338 [print], 1744-764X [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of drug safety and original papers on the clinical implications of drug treatment safety issues, providing expert opinion on the scope for future development.
期刊最新文献
Adverse events associated with aromatase inhibitors: an analysis of real-world datasets and drug-gene interaction network. Real-world analysis of levetiracetam-associated rhabdomyolysis: insights from the FDA adverse event reporting system. Ocular adverse events associated with GLP-1 receptor agonists: a real-world study based on the FAERS database and network pharmacology. Is metformin safe in pregnancy: a focus on offspring outcomes. Drug-induced noninfectious myocarditis: a disproportionality analysis of the FAERS database.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1