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Patients taking neuroleptics were 5.4 times more likely to begin antiparkinsonian medication than were nonusers(95%confidence interval[CI] 4.8 to 6.1).They also had a greater than two-fold increase in risk of beginning therapy with dopaminergic drug specific for idiopathic Parkinson's disease,not generally indicated for treatment of drug-induced parkinsonism(adjusted odds ratio 2.2,95%CI 1.9 to 2.7).Clear dose-response relationships were demonstrated,as were differences among neuroleptics. Among all patients started on dopaminergic drugs in this population,37%of such therapy was attributable to prior neuroleptic use.Continuation of the neuroleptic persisted in 71%of patients so treated.Neuroleptic use is a common cause of extrapyramidal dysfunction in the elderly,and the side effect is frequently treated by adding an anticholinergic or dopaminergic drug to the regimen.The use of anticholinergic drugs presents risks of additional drug side effects;the use of dopaminergic drug,generally not appropriate for drug-induced parkinsonian syndrome,suggests that extrapyramidal neuroleptic side effects may often be mistaken for idiopathic Parkinson's disease in older patients. |
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adverse drug reaction
anticholinergic drugs
drug induced neurologic disorders
L-dopa
misdiagnosis
movement disorder,drug induced
neuroleptic
old age,neurology of
Parkinson disease
Parkinson disease,diagnosis
Parkinson disease,drug induced
Parkinson disease,misdiagnosis
sinemet
treatment of neurologic disorder
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