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Extrapyramidal effects of neuroleptics.
Journal of Neurology, Neurosurgery, and Psychiatry
|September 1, 1976
Summary
Long-term tranquilizer use in psychiatric patients frequently causes Parkinsonism. Orphenadrine effectively treated Parkinsonism in most patients, though some experienced worsened symptoms.
Area of Science:
- Psychiatry
- Neurology
- Pharmacology
Background:
- Major tranquilizers are widely prescribed for psychiatric inpatients.
- Long-term use of these medications can lead to extrapyramidal side effects, including Parkinsonism.
- Parkinsonism is a significant concern impacting patient quality of life.
Purpose of the Study:
- To investigate the frequency of Parkinsonism in psychiatric inpatients on long-term tranquilizer therapy.
- To evaluate the efficacy of orphenadrine in treating drug-induced Parkinsonism.
- To explore factors influencing the development of Parkinsonism.
Main Methods:
- A double-blind crossover study was conducted on 66 psychiatric inpatients.
- Patients had been on major tranquilizers for 4 to 16 years.
- Orphenadrine's effects on Parkinsonism signs were assessed and compared to placebo.
Main Results:
- 61% of patients exhibited signs of Parkinsonism.
- Parkinsonism was more frequent in female patients and those with organic brain pathology, though not statistically significant.
- No correlation was found between tranquilizer duration and extrapyramidal effects.
- 25 out of 40 patients with Parkinsonism showed improvement with orphenadrine.
- 6 patients (15%) experienced more severe Parkinsonism symptoms with orphenadrine than placebo.
Conclusions:
- Long-term major tranquilizer use is associated with a high incidence of Parkinsonism in psychiatric inpatients.
- Orphenadrine demonstrates therapeutic potential for managing drug-induced Parkinsonism.
- Individual patient responses to orphenadrine vary, necessitating careful monitoring.