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Mov Disord. 2016 May;31(5):632-6. doi: 10.1002/mds.26595. Epub 2016 Mar 29.

Atropinic (Anticholinergic) Burden in Parkinson's Disease.

De Germay S1,2,3, Montastruc JL1,2,3,4,5, Rousseau V1,2,3,4, Chebane L1,2, Bondon-Guitton E1,2,3, Moulis F1,2, Durrieu G1,2, Bagheri H1,2,3,5, Rascol O1,4,5,6, Pariente A7,8, Bégaud B7,8, Montastruc F1,2,3,4,5,7.

Author information

1
Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire et Faculté de Médecine de Toulouse, Toulouse, France.
2
Centre Midi-Pyrénées de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament et Pharmacopôle Midi-Pyrénées, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
3
INSERM UMR 1027, Faculté de Médecine, Université de Toulouse, Toulouse, France.
4
CIC INSERM 1436, Université et Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
5
NeuroToul Centre of Excellence in Neurodegeneration, Université et Centre Hospitalier Universitaire, France.
6
INSERM UMR 825, Université de Toulouse, Toulouse, France.
7
Département de Pharmacologie, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
8
INSERM U 657, Pharmacoepidemiology, Université et Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.

Abstract

Use of atropinic drugs remains controversial in Parkinson's disease (PD) because there is insufficient evidence about their efficacy and they can induce serious adverse drug reactions. Atropinic risk scales were developed to help to identify atropinic drugs in prescription forms and to evaluate their burden in clinical practice. In the present review, we discuss the few studies investigating atropinic burden in PD and present the results of our study indicating that atropinic drugs are still widely prescribed in PD (almost 3 of 5 prescriptions) with a clinically significant atropinic burden in around 1 of 6 PD patients. Drugs mainly responsible for high values of atropinic burden were those used for nonmotor symptoms. Clinically significant atropinic burdens were mainly induced by associations of several "low-risk" drugs. Physicians must be aware that in addition to classical atropinic antiparkinsonian drugs, many others (psychotropics) can contribute to increased atropinic burden in PD patients.

KEYWORDS:

Parkinson's disease; anticholinergic burden; anticholinergic drugs; atropinic burden; atropinic drugs

PMID:
27028036
DOI:
10.1002/mds.26595
[Indexed for MEDLINE]

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