Parkinsonism

[btdt]

https://en.wikipedia.org/wiki/Parkinsonism

 

Parkinsonism is a clinical syndrome characterized by tremor,bradykinesia, rigidity, and postural instability.^[1][2] Parkinsonism shares symptoms found in Parkinson's disease, from which it is named; but parkinsonism is a symptom complex, and differs from Parkinson disease which is a progressive neurodegenerative illness. The underlying causes of parkinsonism are numerous, and diagnosis can be complex.^[3][4] The neurodegenerative condition Parkinson's disease(PD) is the most common cause of parkinsonism. However, a wide range of other etiologies may lead to a similar set of symptoms, including some toxins, a few metabolic diseases, and a handful of neurological conditions other than Parkinson's

About 7% of people with parkinsonism have developed their symptoms following treatment with particular medications. Side effect of medications, mainly neuroleptic antipsychotics especially the phenothiazines (such as perphenazine and chlorpromazine), thioxanthenes (such as flupenthixol and zuclopenthixol) and butyrophenones(such as haloperidol (Haldol)), piperazines (such as ziprasidone), and, rarely, antidepressants. The incidence of drug-induced parkinsonism increases with age. Drug induced parkinsonism tends to remain at its presenting level, i.e. does not progress like the parkinson disease.^[6]

 

 

No doctor said the name to me but I had head drops a foot dragging when on my last AD I think it wise to keep possible issues in view should symptoms appear the hope is that it does not progress the word "tends" is not very comforting to me.  

I have had a leg and arm that shake since the last car accident lessening in time now it is mostly the leg.  I looked up some pictures of this today that was a mistake don't look  just know this is possible.  Caused by the blocking of dopamine?  I think that is what they think... Effexor has been thought to be a low effect on dopamine but some have thought the dopamine blocking to be responsible for the loss of love in relationships and failure of marriage... also the thrill seeking of affairs or other dangerous activities... stripping for instance releases the dopamine the brain is starved for... Just some of us had these sort of issues while on Effexor  I for instance became a stripper... if you looked at my life and my past it would seem a very unlikely job choice based on my past. 

 

https://www.parkinsons.org.uk/sites/default/files/publications/download/english/fs38_druginducedparkinsonism.pdf

 

"What are the characteristics of druginduced parkinsonism and how does it differ from idiopathic Parkinson’s? Drug-induced parkinsonism is more likely to be symmetrical (on both sides of the body) and less likely to be associated with tremor, although it can sometimes present asymmetrically and with a tremor. Akinesia with loss of arm swing can be the earliest feature. Bradykinesia can be an early common symptom, causing expressionless face, slow initiation of movement and speech difficulties. Other drug-induced movement disorders Tardive dyskinesia is another drug-induced movement disorder that can occur in people who are on neuroleptic drugs. This refers to excessive movement of the lips, tongue and jaw (known as oro-facial dyskinesias). The term ‘tardive’ means delayed or late appearing and this refers to the fact that the person may have been treated with the neuroleptic for some time before the dyskinesia becomes apparent. Tardive dyskinesia can be difficult to treat and may, sadly, be permanent in some people.

 

Awareness is important is reversing the symptoms as quickly as possible stopping the drugs doe sit work...

If the offending drug is stopped, will the drug-induced parkinsonism improve and if so, how long will this take? Generally, 60% of people will recover within two months, and often within hours or days, of stopping the offending drug. However, some people may take as long as two years. One study reported that 16% of cases went on to be confirmed to have idiopathic Parkinson’s. These people were probably going to develop Parkinson’s at some stage in the future in any event, but the offending drug ‘unmasked’ an underlying dopamine deficiency. This theory is supported by research studies with specialist PET scans.( maybe)

 

Even if you have this tapering is important.. tho I was not tapered

What other treatment is available? In many cases, the first approach to treatment will be to try stopping the offending drug for a sufficient length of time, reducing it, or changing it to another drug that may be less likely to cause drug-induced parkinsonism. Please note: you should not stop taking any drug because you think it is causing druginduced parkinsonism, or worsening existing Parkinson’s without first discussing the situation with your doctor. Some drugs need to be withdrawn slowly, particularly if the person has been taking the drug for a considerable time, and problems can arise if they are withdrawn abruptly. Sometimes, for medical reasons, the person cannot stop taking the drug that causes drug-induced parkinsonism. Where this is the case, the benefits of the drug need to be weighed against the side effects of parkinsonism.

 

The levels of serotonin are abnormal in brains of people with Parkinson’s and the findings of the BBC Horizon programme have suggested that further research into the relationship between serotonin and Parkinson’s is needed and may lead in the future to new non-dopaminergic treatments for the condition

 

Much more at the link

 

drugs that can cause it

Table 1: List of neuroleptic drugs available in the UK Generic name Trade name Amisulpride Solian Chlorpromazine hydrocloride Chloractil/Largactil Clozapine Clozaril, Denzapine Flupenthixol Depixol Fluphenazine hydrochloride Modecate/Moditen/Motival (includes nortriptyline) Haloperidol Dozic/Haldol/Serenace Methotrimeprazine/Levomepromazine Nozinan Olanzapine Zyprexa Oxypertine Oxypertine Pericyazine Neulactil Perphenazine Fentazin, Triptafen (Perphenazine+amitriptyline) Pimozide Orap Pipotiazine Piportil Prochlorperazine Stemetil Promazine hydrochloride Promazine Quetiapine Seroquel Risperidone Risperdal Sulpiride Domatil/Sulpitil/Sulpor (Sulparex is discontinued) Thioridazine Melleril Trifluoperazine Stelazine Zuclopenthixol acetate Clopixol Zotepine Zoleptil

 

Table 2: Other drugs that can cause drug-induced parkinsonism Generic name Trade name Used to treat Amiodarone Cordarone X Heart problems Cinnarizine Stugeron Nausea and vomiting, motion sickness, vertigo, dizziness, tinnitus, vascular disease and Raynaud’s syndrome, high blood pressure, abnormal heart rhythm, angina pectoris, panic attacks, manic depression and migraine Fluphenazine Motival, Motipress A combination of antidepressant and with nortriptyline antipsychotic drug Lithium Camcolit, Li-Liquid, Liskonum, Priadel Depression Methyldopa Aldomet High blood pressure Metoclopramide Maxolon For sickness and indigestion. Also included in some medicines used migraine such as Paramax (with paracetamol) and Migramax (with aspirin) Prochlorperazine Stemetil Dizziness and nausea Tranylcypromine Parnate Depression

 

 

I noticed there is not on Ad on the list tho it mentions them in the article and I know for sure parkinsonism is on the list of side effects for Effexor. 

 

 

[Junglechicken]

How ironic - my father suffers from Parkinsonism. He is 81.

 

It was because of his financial irresponsibility that I ended up on ADs and then subsequent WD.

[btdt]

Was his parkinsonism drug induced?

[Junglechicken]

No btdt.

 

We thought he had had a stroke, but it turned out to be Parkinsonism.

[btdt]

So what caused it?

 

Do you mean parkinsons it is different than parkinsonism.

[btdt]

a good source here of possible metabolic causes it does not mean to me that the drug did not cause the metabolic cause of P ism...some issues I found here that I have noticed are commonly involved or noted  with Ad use

 

Thyroid Disease. Hypothyroidism shares many features in common with parkinsonism -- including rigidity, fatigue, masked facial expression, constipation, depression, and slowed movements, speech, and gait -- but can be distinguished from Parkinson's disease by other medical features and diagnostic studies of endocrine dysfunction. The development of hypothyroidism in the setting of Parkinson's disease may be mistaken for worsening parkinsonism, but the symptoms can improve with thyroid hormone replacement.^[1] Conversely, hyperthyroidism may mimic the weight loss or increased sweating seen with Parkinson's disease or may exaggerate parkinsonian tremor, and improvement occurs with antithyroid treatment.^[2]

Electrolyte Disturbance. Extrapontine and central pontine myelinolysis syndromes can occur in the setting of chronic alcohol use, liver disease, rapid correction of sodium electrolyte imbalance, or malnutrition. Rarely, these syndromes may be associated with a subacute course of parkinsonism, often with neuropsychiatric symptoms and dystonia, which may respond to levodopa treatment.^[16]

Mitochondrial Disease. Parkinsonism may be observed in up to 12% of adult patients with respiratory chain disorders associated with mitochondrial dysfunction, including Leber hereditary optic neuropathy. Additional features usually include myopathy, polyneuropathy, progressive external ophthalmoplegia, and premature menopause. In this context, levodopa may improve parkinsonism and cause drug-induced dyskinesias

Renal FailureCalcium Disorders.Liver Failure.   also covered as causes at this link

 

http://www.medscape.com/viewarticle/705907_2

 

 

also a list of drugs not exactly the same as the first source

Drugs

A variety of drugs commonly used in the treatment of medical disease may cause drug-induced parkinsonism, and may account for up to 20% of cases of parkinsonism in a community setting.^[44] In contrast to Parkinson's disease, women are affected more commonly than men.

 

Dopamine Receptor-blocking Medications. Drug-induced parkinsonism can occur in patients treated with dopamine receptor blockers, such as antipsychotics (haloperidol, risperidone, perphenazine), antiemetic agents (prochlorperazine, promethazine), and prokinetic agents (metoclopramide). A history of dopamine receptor-blocking medication use may not be offered up front, requiring specific questioning about their use in the evaluation of new-onset parkinsonism. Metoclopramide, a frequently used drug in the treatment of gastroparesis, esophagitis, nausea, and vomiting, may account for up to 29% of drug-induced parkinsonism in the elderly (with average age of 69), second only to antipsychotics.^[45] Although drug-induced parkinsonism may be less prevalent in patients treated with atypical, newer generation antipsychotics compared with traditional neuroleptics, the risk is still clinically pertinent. Discontinuation of the offending agent usually leads to recovery in several weeks or months.

Other Medications. Among the other medications used to treat medical diseases that are reported to cause reversible parkinsonism or exacerbate Parkinson's disease in small series or single case histories are calcium channel blockers (diltiazem, nifedipine, verapamil), monoamine depleters (reserpine, tetrabenazine), antiarrhythmic drugs (amiodarone), anticonvulsants (phenytoin, sodium valproate), immunosuppressants or chemotherapeutic agents (cyclosporine, vincristine, busulfan, cytosine arabinoside, doxorubicin), lithium, procaine, α-methyldopa, chloroquine, buspirone, and high doses of diazepam.^[40] When the drug is stopped, parkinsonism improves; in those cases where parkinsonism persists, it is probable that the patient had early Parkinson's disease unmasked by the drug I wonder if this is the same as ssri type drugs unmasking bopolar and around we go... 

[Altostrata]

btdt, are you trying to scare people? There is a catalog of neurological diseases, why are you posting about this one?

[Junglechicken]

Btdt - he just developed it, which some people do in old age.

 

Yes Parkinsonism is different to Parkinsons.

[btdt]

New xrays of my back show some of the same signs... have not talked to the doc yet it got my blood boiling I know I am jumping the gun but if some people are on the fence about drugs it is good to know ahead of time what they can cause.  This is one nobody ever thinks they will get.  I may not have it now I may not have had it when I was told to quit Effexor but I had something then and I have something still. I shake rattle and roll and not to music.  I thought for a time it was drug or accident related as I had it for a good while after ct then it seemed to go away.  It came back post accident arm and leg both shaking at the same time .. then entire body shakes with puffers when I had breathing problems I still have it in one leg the same one that was dragging when I was told I had to get off Effexor.  I read the xray report today and looked up some of the terms and googled myself into a state ... wala.... parkinsonism post. 

 

Am I trying to scare people not really that is and was not the motive for the post... it was a warning, even tho I doubt many here are on the fence should any of these symptoms kick up it would be good to know right away it could be related to the drugs. I took me a long time to get to a doctor who would say I had to stop taking effexor he did not say the symptoms were caused by effexor not straight up .. not that I can recall but truthfully I can't recall things very well if he did say it I may not recall. 

[btdt]

It is likely unlikely and I fell for it again... stress and strain of trying to live and knew jerk reaction to seek knowledge since it feels knowledge was withheld for a long time as in wd.. now I have a need to know gene that is like an auto immune disease it eats me while it is active.. there is no winning with this... I know it still I can't always stop it till challenged and now always receptive to challenge depends on the day. 

peace all

[papaloapan]

I had it as a side effect of haldol, when they injected me haldol, they also gave me haldol in pills, and also pills of biperiden and triazolam, one of this last two was given to me to heal the parkinson side effect of haldol but it didn't work. Days later the psychiatrist gave me another pill for healing the parkinson,and after 20 days of the most intense hell of all, a mix of the most intense parkinson, akathisia, anxiety, insomnia, my body healed and adapted and the hellish symptoms dissapeared.