Treatment of drug-induced parkinsonism

Abstract

Drug-induced parkinsonism (DIP) is a common movement disorder characterized by the rapid development of a most commonly symmetrical and akinetic-rigid syndrome weeks after initiation of a causative medication that resolves completely within months after withdrawal. Besides neuroleptics, the list of medications known to induce parkinsonism is long and includes, among many others, calcium channel blockers, antidepressants, and antiepileptics. Most have in common to alter dopaminergic transmission, more specifically D2 receptor-mediated motor modulation in the striatum. DIP and Parkinson’s disease (PD) may be virtually indistinguishable, yet some particular features may help to separate them. However, in a quarter of suspected DIP cases, the offending agent seems to have unmasked, rather than induced, a preexisting neurodegenerative condition. There is no specific treatment for DIP besides stopping the incriminated medication which, in the majority of patients, is curative.