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Drug-Induced Movement Disorders in Elderly Patients

  • Santiago Perez-LloretEmail author
  • Jean-Louis Montastruc
  • Olivier Rascol
Chapter

Abstract

Movement disorders such as dystonia, akathisia, parkinsonism, chorea, stereotypies, myoclonus, or tics can be observed during exposure to a large number of drugs commonly used for the treatment of diverse medical conditions. The most frequent drugs connected to movement disorders are antipsychotics, but they can also be observed with a variety of drugs, such as metoclopramide, prochlorperazine, cinnarizine, flunarizine, H1 antihistaminergic drugs, trimetazidine, or serotonin reuptake inhibitors. Clinical observation is crucial for differential diagnosis of drug-induced movement disorders. Neuroimaging by positron emission tomography (PET) or single photon emission computed tomography (SPECT) may be of help for diagnosing drug-induced parkinsonism or tardive dyskinesia. The first therapeutic measure is to withdraw the offending drug when possible. When needed, muscarine receptor blockers can be used to treat acute dystonia, propranolol or alprazolam for akathisia, and reserpine or methyldopa for life-threatening tardive syndromes.

Keywords

Drug-induced movement disorders Adverse drug reactions Pharmacovigilance Parkinsonism Akathisia Dystonia Tremor Chorea Myoclonus Tardive syndromes 

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© Springer-Verlag London 2014

Authors and Affiliations

  • Santiago Perez-Lloret
    • 1
    • 2
    Email author
  • Jean-Louis Montastruc
    • 3
  • Olivier Rascol
    • 3
  1. 1.Clinical Pharmacology and Epidemiology Laboratory, Medicine SchoolCatholic University of ArgentinaBuenos AiresArgentina
  2. 2.Département de Pharmacologie et Service de Pharmacologie Clinique, Faculté de Médecine, Centre Midi-Pyrénées de PharmacoVigilance, de Pharmaco épidémiologie et d’Informations sur le Médicamentde l’Université de Toulouse, Centre Hospitalier UniversitaireToulouseFrance
  3. 3.Department of PharmacologyToulouse University HospitalToulouseFrance

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