Chapter: Basic & Clinical Pharmacology : Pharmacologic Management of Parkinsonism & Other Movement Disorders

Drug-Induced Parkinsonism

Reserpine and the related drug tetrabenazine deplete biogenic monoamines from their storage sites, whereas haloperidol, meto-clopramide, and the phenothiazines block dopamine receptors.

DRUG-INDUCED PARKINSONISM

Reserpine and the related drug tetrabenazine deplete biogenic monoamines from their storage sites, whereas haloperidol, meto-clopramide, and the phenothiazines block dopamine receptors. These drugs may therefore produce a parkinsonian syndrome, usually within 3 months after introduction. The disorder tends to be symmetric, with inconspicuous tremor, but this is not always the case. The syndrome is related to high dosage and clears over several weeks or months after withdrawal. If treatment is neces-sary, antimuscarinic agents are preferred. Levodopa is of no help if neuroleptic drugs are continued and may in fact aggravate the mental disorder for which antipsychotic drugs were prescribed originally.

In 1983, a drug-induced form of parkinsonism was discovered in individuals who attempted to synthesize and use a narcotic drug related to meperidine but actually synthesized and self-adminis-tered MPTP, as discussed in the Box: MPTP & Parkinsonism.

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Basic & Clinical Pharmacology : Pharmacologic Management of Parkinsonism & Other Movement Disorders : Drug-Induced Parkinsonism |