DRUGS CAUSING PARKINSON'S DISEASE

17th June
2011 - New research

DRUGS CAUSING PARKINSON'S DISEASE

Movement Disorders [2011] June 14 [Epub ahead of print] (Bondon-Guitton E, Perez-Lloret S, Bagheri H, Brefel C, Rascol O, Montastruc JL.) A study assessing over 20,000 adverse drug reactions has found those drugs that can cause or worsen Parkinson's Disease. This is normally described as drug induced Parkinsonism. Among the suspect drugs, most involved central dopaminergic antagonists (49%), followed by antidepressants (8%), calcium channel blockers (5%), peripheral dopaminergic antagonists (5%), and H1 antihistamines (5%). Cases with lithium, valproic acid, amiodarone, anticholinesterases, or trimetazidine were also found. Some problems occurred due to the interaction of other drugs.

The majority (60%) of people affected were female. Nearly half of all people affected were between 60 and 79 years of age. Seriousness was observed in 44% of cases. Nearly 70% of cases were observed during the first 3 months after introduction of the "suspect" drug (involving mainly central dopaminergic antagonists). A second peak (affecting 20% of cases) was found 12 months after drug introduction (mainly due to calcium channel blockers). The most frequently reported parkinsonian symptom was rigidity. Improvement was favourable after partial or complete withdrawal of suspect drugs in 88% of cases.

URINARY DYSFUNCTION IN PARKINSON'S DISEASE

23rd June
2011 - New research

URINARY DYSFUNCTION IN PARKINSON'S DISEASE

Neurology, Neurosurgery and Psychiatry [2011] June 13 [Epub ahead of print] (Uchiyama T, Sakakibara R, Yamamoto T, Ito T, Yamaguchi C, Awa Y, Yanagisawa M, Higuchi Y, Sato Y, Ichikawa T, Yamanishi T, Hattori T, Kuwabara S.)

Urinary dysfunction is common in Parkinson's Disease, but little was known about urinary dysfunction in early and untreated Parkinson's Disease. After excluding those with other conditions that might have influenced urinary function, patients were evaluated using a urinary questionnaire and urodynamic studies. Nearly two thirds (64%) of those people with Parkinson's Disease complained of urinary symptoms. More than a quarter (28%) had urinary difficulty. The main cause

of urinary difficulty is detrusor underactivity. The detrusor is the muscle that contracts when urinating to squeeze out urine. This is because Parkinson's Disease can affect all muscles, including even those used for urinating. Bladder outlet obstruction was present in 16% of people with Parkinson's Disease. Few patients experienced quality-of-life impairment owing to urinary dysfunction, despite the problems it can cause. The urinary symptoms and urodynamic findings were not correlated with gender, type of Parkinson's Disease, or disease severity, and so were not likely to worsen over time. In cases with severe difficulty in urinating, other diagnoses should be considered.