Antiparkinson Drug Overuse

Abstract

Antiparkinson Dru~s and Phenoxene in relieving akinesia. Their effectiveness in relieving these symptoms has led to the wide-spread use of antiparkinson drugs in psychiatry; a usage which we believe is greater than needed or desirable because of the manner in which they are given and not because we question their efficacy. Prescribed appropriately, we believe that present usage could be cut at least in half. In particular there are two practices that seem not to be warranted on the basis of what is presently known about these drugs: that of administering the antiparkinson drugs as a prophylactic measure, and that of continuing a patient on an antiparkinson drug for as long as the patient is on an anti-psychotic agent. With regard to using the antiparkinson drugs prophylactically, our review of the literature uncovered only 2 articles bearing specifically on this matter. In one phase of their study, Lapolla and Nash administered a phenothiazine and an anti-parkinson agent, biperidin (Akineton), concomitantly to 49 patients who had previously exhibited signs to the same phenothiazine alone. Extrapyramidal symptoms subsequently re-occurred in 12 of the 49 patients on this combined therapy. When they next took all • The use of psychotropic drugs such as the phenothiazines, thioxanthenes, and butyrophenones as effective means of treating schizophrenic patients is a common practice in psychiatry today. From 40 to 70% of all patients in state mental hospitals, at one time or another, are placed on a drug from one of these three classes of antipsychotic agents. It is well-known that frequent accompaniments of treatment with these drugs are the so called extrapyramidal side effects: symptoms such as dystonias, dyskinetic movements, parkinson-like tremors, akathisia, etc. Depending upon the particular psychotropic agent administered, the dose administered, and the ages and sex of the patient populations involved, the incidence of their occurrence has been reported to be from 4 to 50% of the