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Trimetazidine and parkinsonism: A prospective study.
Dávid Pintér1, Márton Kovács2, Márk Harmat2
1Doctoral School of Clinical Neuroscience, Medical School, University of Pécs, Pécs, Hungary.
Parkinsonism & Related Disorders
|January 15, 2019
Summary
Trimetazidine can cause parkinsonian symptoms, but stopping the drug usually resolves these effects. Mild, symmetrical symptoms with normal DaTSCAN imaging suggest drug-induced parkinsonism.
Area of Science:
- Neurology
- Pharmacology
Background:
- Trimetazidine is known to potentially induce parkinsonian symptoms.
- Previous reports have been anecdotal, lacking systematic characterization of this side effect.
Purpose of the Study:
- To systematically investigate parkinsonism occurring during trimetazidine treatment.
- To differentiate drug-induced parkinsonism from idiopathic Parkinson's disease.
Main Methods:
- 33 patients on trimetazidine with new parkinsonian symptoms were studied.
- Neurological, neuropsychological, and DaTSCAN imaging were performed.
- Patients were followed up 1 and 12 months after trimetazidine withdrawal.
Main Results:
- Parkinsonism resolved in 11 patients after trimetazidine withdrawal.
- Reversible parkinsonism was milder, more symmetrical, and characterized by akinesia/rigidity (PIGD) rather than tremors.
- DaTSCAN imaging was normal in reversible cases and abnormal in persistent cases, suggesting underlying Parkinson's disease.
Conclusions:
- Mild, symmetrical parkinsonism with normal DaTSCAN suggests trimetazidine-induced parkinsonism.
- Discontinuation of trimetazidine typically leads to complete remission.
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