Document Detail

Atypical antipsychotic use and parkinsonism in dementia: effects of drug, dose, and sex.
MedLine Citation:
PMID:  23217531     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Differences between atypical antipsychotics in their potential to cause parkinsonism and risk factors for antipsychotic-induced parkinsonism are not well established. There is a particular paucity of information on this in real-world use of these drugs, outside of clinical trial settings.
OBJECTIVE: We compared the incidence of parkinsonism after new treatment with risperidone, olanzapine, or quetiapine in patients with dementia and examined the effects of dose and sex on the risk of parkinsonism.
METHODS: Administrative data from Ontario, Canada between 2002 and 2010 were used to compare the incidence of a diagnostic code for parkinsonism or prescription of an anti-Parkinson medication among patients with dementia who were newly prescribed quetiapine, olanzapine, or risperidone.
RESULTS: From 15,939 person-years of observation, 421 patients developed parkinsonism. Using low-dose risperidone as the reference group, the adjusted hazard ratios for developing parkinsonism were 0.49 (95% CI, 0.07-3.53) for low-dose olanzapine and 1.18 (95% CI, 0.84-1.66) for low-dose quetiapine. Comparing across drugs within the most commonly prescribed dose ranges, the incidence of parkinsonism was higher in the medium-dose olanzapine group compared with the low-dose risperidone group (hazard ratio 1.66; 95% CI 23-2.23). The adjusted hazard ratio for developing parkinsonism for men (compared with women) was 2.29 (95% CI, 1.88- 2.79).
CONCLUSIONS: We found no evidence that the risk of drug-induced parkinsonism in older adults with dementia was different among quetiapine, olanzapine, or risperidone, challenging the notion that the drugs differed in their propensity to cause parkinsonism. Men appeared to be at higher risk of parkinsonism as a adverse event than women.
Connie Marras; Nathan Herrmann; Geoffrey M Anderson; Hadas D Fischer; Xuesong Wang; Paula A Rochon
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of geriatric pharmacotherapy     Volume:  10     ISSN:  1876-7761     ISO Abbreviation:  Am J Geriatr Pharmacother     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101190325     Medline TA:  Am J Geriatr Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-389.e3     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.
Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:
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