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Susceptibility to neuroleptic-induced parkinsonism—age and increased substantia nigra echogenicity as putative risk factors

Published online by Cambridge University Press:  16 April 2020

Burkhard Emanuel Jabs ,
Andreas Joachim Bartsch  and
Bruno Pfuhlmann
Burkhard Emanuel Jabs*
Affiliation:
Department of Psychiatry, Julius-Maximilians-University, Füchsleinstraße 15, 97080Würzburg, Germany
Andreas Joachim Bartsch
Affiliation:
Division of Neuroradiology, Julius-Maximilians-University, Josef-Schneider-Str. 11, 97080Würzburg, Germany
Bruno Pfuhlmann
Affiliation:
Department of Psychiatry, Julius-Maximilians-University, Füchsleinstraße 15, 97080Würzburg, Germany
*
*E-mail address: burkhard.jabs@mail.uni-wuerzburg.de
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Abstract

Objective

Patients treated by neuroleptics often develop neuroleptic-induced parkinsonism (NIP) to a varying extent. The reasons for this are discussed controversially in the literature. Previous transcranial sonography (TCS) findings of the substantia nigra (SN) in patients with idiopathic Parkinson’s disease suggest a correlation of echogenicity with nigrostriatal dysfunction.

Methods

One hundred psychiatric patients receiving neuroleptics were included. They underwent clinical examination for NIP (Simpson and Angus-scale) and, independently, TCS of the SN. History of smoking habits and medication were taken from the patient’s chart.

Results

We found a significant positive association of the prevalence of NIP with age (P < 0.01) and the echogenic area of the SN (P < 0.05). Neither type nor dosage of the neuroleptics was found to have any significant impact on the occurrence of NIP. Smokers displayed lower prevalence of NIP (P < 0.05) and lower EPS scores (P < 0.01).

Conclusions

These findings suggest that age and increased size of SN echogenicity are possible risk factors for NIP. In contrast, smoking seems to have a certain protecting effect.

Keywords

Antipsychotic agentsAdverse effectsSecondary Parkinson’s diseaseTranscranial ultrasonographySubstantia nigra
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 4 , June 2003 , pp. 177 - 181
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

Aceto, MD, Martin, BR. Central actions of nicotine. Med Res Rev 1982;2:43–62.CrossRefGoogle ScholarPubMed
Batra, A. Tabakabhängigkeit und Raucherentwöhnung bei psychiatrischen Patienten. Fortschr Neurol Psychiat 2000;68:80–92.Google Scholar
Becker, G, Seufert, J, Bogdahn, U, Reichmann, H, Reiners, K. Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography. Neurology 1995;45:182–4.CrossRefGoogle ScholarPubMed
Berg, D, Becker, G, Zeiler, B, Tucha, O, Hofmann, E, Preier, M, et al. Vulnerability of the nigrostriatal system as detected by transcranial ultrasound. Neurology 1999;53:1026–31.CrossRefGoogle ScholarPubMed
Burn, DJ, Brooks, DJ. Nigral dysfunction in drug-induced parkinsonism: an 18F-dopa PET study. Neurology 1993;43:552–6.CrossRefGoogle Scholar
Caligiuri, MP, Lohr, JB. Instrumental motor predictors of neurolepticinduced parkinsonism in newly medicated schizophrenia patients. J Neuropsychiatry Clin Neurosci 1997;9:562–7.Google Scholar
Decina, P, Caracci, G, Sandik, R, Berman, W, Mukherjee, S, Scapicchio, PL. Cigarette smoking and neuroleptic-induced parkinsonism. Biol Psychiatry 1990;28:502–8.CrossRefGoogle ScholarPubMed
Ereshefsky, L, Saklad, SR, Watanabe, MD, Davis, CM, Jann, MW. Thiothixene pharmacokinetic interactions: a study of hepatic enzyme inducers, clearance inhibitors, and demographic variables. J Clin Psychopharmacol 1991;11:296–301.CrossRefGoogle ScholarPubMed
Farde, L, Wiesel, FA, Halldin, C, Sedvall, G. Central D2-dopamine receptor occupancy in schizophrenic patients treated with antipsychotic drugs. Arch Gen Psychiatry 1988;45:71–6.CrossRefGoogle ScholarPubMed
Fowler, JS, Volkow, ND, Wang, GJ, Pappas, N, Logan, J, MacGregor, R, et al. Neuropharmacological actions of cigarette smoke: brain monoamine oxidase B (MAO B) inhibition. J Addict Dis 1998;17:23–34.CrossRefGoogle ScholarPubMed
Gerlach, J. The continuing problem of extrapyramidal symptoms: strategies for avoidance and effective treatment. J Clin Psychiatry 1999;60(Suppl 23):20–4.Google ScholarPubMed
Gil-ad, I, Shtaif, B, Shiloh, R, Weizman, A. Evaluation of the neurotoxic activity of typical and atypical neuroleptics: relevance to iatrogenic extrapyramidal symptoms. Cell Mol Neurobiol 2001;21:705–16.CrossRefGoogle ScholarPubMed
Glassman, AH, Helzer, JE, Covey, LS, Cottler, LB, Stetner, F, Tipp, JE, et al. Smoking, smoking cessation, and major depression. JAMA 1990;246:1546–9.CrossRefGoogle Scholar
Goff, DC, Henderson, DC, Amico, E. Cigarette smoking in schizophrenia: relationship to psychopathology and medication side effects. Am J Psychiatry 1992;149:1189–94.Google ScholarPubMed
Hamera, E, Schneider, JK, Deviney, S. Alcohol, cannabis, nicotine, and caffeine use and symptom distress in schizophrenia. J Nerv Ment Dis 1995;183:559–65.CrossRefGoogle Scholar
Hardie, RJ, Lees, AJ. Neuroleptic-induced Parkinson’s syndrome clinical features and results of treatment with levodopa. J Neurol Neurosurg Psych 1988;51:850–4.CrossRefGoogle ScholarPubMed
Hoffman, WF, Labs, SM, Casey, DE. Neuroleptic-induced parkin-sonism in older schizophrenics. Biol Psychiatry 1987;22:427–39.CrossRefGoogle Scholar
Jabs, BE, Berg, D, Merschdorf, U, Pfuhlmann, B, Bartsch, AJ, Toyka, KV, et al. Difference of substantia nigra echogenicity in noso-logical subtypes within the schizo-phrenic spectrum—a preliminary transcranial ultrasound study. Neuropsychobiology 2001;44:183–6.CrossRefGoogle Scholar
Jahn, T, Mussgay, L. Die statistische Kontrolle möglicher Medikamenteneinflüsse in experimentalpsychologischen Schizophreniestudien: Ein Vorschlag zur Berechnung von Chlorpromazinäquivalenten. Z Klin Psychol 1989;18:257–67.Google Scholar
Keepers, GA, Clappison, VJ, Casey, DE. Initial anticholinergic prophylaxis for neuroleptic induced extrapyramidal syndromes. Arch Gen Psychiatry 1983;40:1113–7.CrossRefGoogle ScholarPubMed
Lemmens, P, Brecher, M, van Baelen, B. A combined analysis of double-blind studies with risperidone vs. placebo and other antipsychotic agents: factors associated with extrapyramidal symptoms. Acta Psychiatr Scand 1999;99:160–70.CrossRefGoogle ScholarPubMed
Meisenzahl, EM, Dresel, S, Frodl, T, Schmitt, GJ, Preuss, UW, Rossmüller, B, et al. D2 receptor occupancy under recommended and high doses of olanzapine: an iodine-123-iodobenzamide SPECT study. J Psychopharmacol 2000;14:364–70.CrossRefGoogle ScholarPubMed
Raedler, TJ, Knable, MB, Lafargue, T, Urbina, RA, Egan, MF, Pickar, D, et al. In vivo determination of striatal dopamine D2 receptor occupancy in patients treated with olanzapine. Psychiatry Res 1999;90:81–90.CrossRefGoogle ScholarPubMed
Rajput, AH, Rozdilsky, B, Hornykiewicz, O, Shannak, K, Lee, T, Seeman, P. Reversible drug-induced parkinsonism. Clinicopathologic study of two cases. Arch Neurol 1982;39:644–6.CrossRefGoogle ScholarPubMed
Salokangas, RKR, Saarijärvi, S, Taiminen, T, Lehto, H, Niemi, H, Ahola, V, et al. Effect of smoking on neuroleptics in schizophrenia. Schizophr Res 1997;23:55–60.CrossRefGoogle Scholar
Sandyk, R. Cigarette smoking: effects on cognitive function and druginduced parkinsonism in chronic schizophrenia. Int J Neurosci 1993;70:193–7.CrossRefGoogle Scholar
Simpson, GM, Angus, JW. A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970;212:11–9.CrossRefGoogle ScholarPubMed
Tauscher, J, Kufferle, B, Asenbaum, S, Tauscher-Wisniewski, S, Kasper, S. Striatal dopamine-2 receptor occupancy as measured with [123I]iodobenzamide and SPECT predicted the occurrence of EPS in patients treated with atypical antipsychotics and haloperidol. Psychopharmacology 2002;162:42–9.CrossRefGoogle ScholarPubMed
World Health Organization. The ICD-10—classification of mental and behavioral disorders. Clinical descriptions and guidelines, vol. 1. Geneva: WHO; 1992.Google Scholar
Ziedonis, DM, Kosten, TR, Glazer, WM, Frances, RJ. Nicotine dependence and schizophrenia. Hosp Community Psychiatry 1994;45:204–6.Google Scholar
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