Drug-induced parkinsonism: what should a psychiatrist know?

Vásquez-Builes, Santiago; Salazar-Duque, Catalina; Tieck-Fernández, María P.; Rojas-Gallego, Isabel C.; Silva, Gustavo Adolfo Díaz

doi:10.24875/rmn.20000010

RMN

2021

DOI: 10.24875/rmn.20000010

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Drug-induced parkinsonism: what should a psychiatrist know?

Santiago Vásquez-Builes¹,

Catalina Salazar-Duque²,

María P. Tieck-Fernández³

et al.

Abstract: Drug-induced parkinsonism is the main cause of secondary parkinsonism in the world. Antipsychotics, antidepressants, and mood stabilizers are the most common drugs implicated in the parkinsonism. This is why psychiatrists and neurologists must have deep knowledge of the diverse aspects of these disorders, to take the best diagnostic and therapeutic approaches.

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2024

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Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

Nichols,

Alty

2024

Australasian Journal of Neuroscience

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Drug induced parkinsonism (DIP) is one of the most frequently occurring side effects of dopamine-receptor blocking agents such as antipsychotic (neuroleptic) and antiemetic drugs. It typically presents with extrapyramidal signs, such as slowed movements, reduced facial expression and muscle stiffness. In contrast to Parkinson’s disease, which is caused by a progressive degeneration of pre-synaptic dopaminergic neurons that project from the substantia nigra in the brainstem, DIP is thought to usually occur due to the post-synaptic antagonism of dopamine receptors in the striatum. However, the two conditions can sometimes be clinically indistinguishable, and may even occur together, and thus it can be challenging to make an accurate diagnosis of DIP. It is important to consider DIP in the differential diagnosis of any person with extrapyramidal signs within the context of recent medication changes as the condition is reversible when the offending drug is withdrawn and, without early identification, there is substantial risk of increased morbidity, complications such as falls, and poor quality of life. Recent advancements in cerebral imaging have improved diagnostic accuracy but this technology is costly and not widely available. There is a dearth of literature pertaining to the role of neuroscience nurses and DIP. This is concerning as the potential for DIP presentations to occur within the neuroscience setting is high. Neuroscience nurses, particularly those working within the movement disorder speciality areas, need the skills to advocate and pursue further investigation for patients who present with extrapyramidal signs, especially if these begin in the context of the prescription of dopamine-blocking drugs. This review is written primarily for neurosciences nurses but will be applicable to a wide range of healthcare workers; it aims to outline potential causative drugs, risk factors and the key clinical characteristics of DIP. It also highlights useful features that help distinguish DIP from Parkinson’s disease, summarises investigations and discusses management and care.

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Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

Nichols,

Alty

2024

Australasian Journal of Neuroscience

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Drug-induced parkinsonism: what should a psychiatrist know?

Cited by 1 publication

References 43 publications

Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

Identifying and Managing Drug Induced Parkinsonism: The Role of Neuroscience Nurses

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