Improvement in Drug-Induced Parkinsonism With Electroconvulsive Therapy

Baez, Maria Andrea; Avery, Jonathan

doi:10.1016/j.amjopharm.2011.04.005

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…Elderly patients with parkinsonism may lose self-care capacity, which may lead to drug treatment noncompliance. Case reports and series demonstrated that ECT was an effective treatment for antipsychotic-induced severe or persistent parkinsonism [148–151], suggesting that ECT may be an alternative treatment option if resolution of movement complications is required.…”

Section: Evidence Base For Ect Effectiveness Efficacy and Tolerabilitymentioning

confidence: 99%

Current electroconvulsive therapy practice and research in the geriatric population

2014

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SUMMARY Electroconvulsive therapy (ECT) is utilized worldwide for various severe and treatment-resistant psychiatric disorders. Research studies have shown that ECT is the most effective and rapid treatment available for elderly patients with depression, bipolar disorder and psychosis. For patients who suffer from intractable catatonia and neuroleptic malignant syndrome, ECT can be life saving. For elderly patients who cannot tolerate or respond poorly to medications and who are at a high risk for drug-induced toxicity or toxic drug interactions, ECT is the safest treatment option. Organic causes are frequently associated with late-life onset of neuropsychiatric conditions, such as parkinsonism, dementia and stroke. ECT has proven to be efficacious even when these conditions are present. During the next decade, research studies should focus on the use of ECT as a synergistic therapy, to enhance other biological and psychological treatments, and prevent symptom relapse and recurrence.

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Section: Evidence Base For Ect Effectiveness Efficacy and Tolerabilitymentioning

confidence: 99%

Current electroconvulsive therapy practice and research in the geriatric population

2014

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“…During the review, there were three published reports regarding patients with drug-induced Parkinsonism and ECT treatment, with all showing a decrease in their symptoms [37][38][39]. One of the studies reported a complete resolution of dementia after 19 ECT treatments in a PD female with a major depressive episode and psychotic features [37], while another study reported an improvement in drug-induced parkinsonism following eight bilateral ECT sessions, which lasted for six months after the end of the treatment [39]. The patients received 19, 10, and eight treatments of ECT, respectively [37][38][39].…”

Section: Drug-induced Parkinsonismmentioning

confidence: 99%

“…One of the studies reported a complete resolution of dementia after 19 ECT treatments in a PD female with a major depressive episode and psychotic features [37], while another study reported an improvement in drug-induced parkinsonism following eight bilateral ECT sessions, which lasted for six months after the end of the treatment [39]. The patients received 19, 10, and eight treatments of ECT, respectively [37][38][39]. One patient's movement disorder improved such that he had only mild bradykinesia at the time of discharge [37].…”

Section: Drug-induced Parkinsonismmentioning

confidence: 99%

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Efficacy of Electroconvulsive Therapy for the Treatment of Movement Disorders: A Literature Review

Nazar¹,

Brooks²,

Chatham³

et al. 2023

Cureus

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Electroconvulsive therapy (ECT) is a safe and effective treatment modality for various psychiatric disorders. However, evidence suggests a putative role of ECT in treating movement disorders that are refractory to less invasive modalities. ECT is primarily used in treatment-resistant psychiatric disorders. However, growing evidence exists for its use in movement disorders with and without psychiatric comorbidity.The primary objective of this systematic review was to examine the efficacy of ECT as a primary treatment modality for movement disorders. Relevant, peer-reviewed publications were retrieved from PubMed, SCOPUS, CINAHL, and PsycINFO. Keywords related to ECT and movement disorders were used as search phrases to identify relevant articles. A total of 90 articles that met the inclusion criteria were included in this review. Core findings were subsequently appraised on the role of ECT in treating movement disorders.Inclusion and exclusion criteria were developed to guide the search and selection process. Sources that met the inclusion criteria were those published between 2001 and January 2023. Additionally, peer-reviewed journals published in the English language covering the role of ECT in movement disorders were deemed appropriate for inclusion. Sources published before 2001, written in a non-English language, and not from peer-reviewed journals were excluded from this systematic review. The exclusion criteria also entailed eliminating duplicates from the review list.Most reviewed sources revealed that ECT improved outcomes in symptoms associated with various movement symptoms. However, ECT does not have a long-lasting impact on neuroacanthocytosis symptoms. Additionally, ECT is negatively associated with aggression and agitation, two of the most critical movement symptoms of Alzheimer's disease.Evidence affirms the efficacy of ECT in providing symptomatic relief for movement disorders aside from psychiatric comorbidities. This positive association highlights the need for randomized controlled studies to identify movement disorder sub-populations that may respond to ECT.

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“…Beneficial effects of electroconvulsive therapy (ECT) on both psychiatric complications and motor symptoms of IPD have been observed since 1947 [121]. In refractory cases of AIP, where previous management steps have not been successful in ameliorating parkinsonism, case reports suggest that ECT could be an effective option for older patients [122,123], although the evidence base is weak, with no RCTs available. A proposed mechanism of the antiparkinsonian effect of ECT is that it increases the sensitivity of dopamine receptors [121].…”

Section: Electroconvulsive Therapymentioning

confidence: 99%

Recognition and Management of Antipsychotic-Induced Parkinsonism in Older Adults: A Narrative Review

Wisidagama

Selladurai

et al. 2021

Medicines

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Background: Parkinsonism is a common side-effect of antipsychotic drugs especially in older adults, who also present with a higher frequency of neurodegenerative disorders like Idiopathic Parkinson’s disease (IPD). Distinguishing between antipsychotic-induced parkinsonism (AIP) and IPD is challenging due to clinical similarities. Up to 20% of older adults may suffer from persisting parkinsonism months after discontinuation of antipsychotics, suggesting underlying neurodegeneration. A review of the literature on AIP in older adults is presented, focusing on epidemiology, clinical aspects, and management. Methods: A literature search was undertaken on EMBASE, MEDLINE and PsycINFO, for articles on parkinsonism induced by antipsychotic drugs or other dopamine 2 receptor antagonists in subjects aged 65 or older. Results: AIP in older adults is the second most common cause of parkinsonism after IPD. Older age, female gender, exposure to high-potency first generation antipsychotics, and antipsychotic dosage are the main risk factors. The clinical presentation of AIP resembles that of IPD, but is more symmetrical, affects upper limbs more, and tends to have associated motor phenomena such as orofacial dyskinesias and akathisia. Presence of olfactory dysfunction in AIP suggests neurodegeneration. Imaging of striatal dopamine transporters is widely used in IPD diagnosis and could help to distinguish it from AIP. There is little evidence base for recommending pharmacological interventions for AIP, the best options being dose-reduction/withdrawal, or switching to a second-generation drug. Conclusions: AIP is a common occurrence in older adults and it is possible to differentiate it from IPD. Further research is needed into its pathophysiology and on its treatment.

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Improvement in Drug-Induced Parkinsonism With Electroconvulsive Therapy

Cited by 11 publications

References 20 publications

Current electroconvulsive therapy practice and research in the geriatric population

Current electroconvulsive therapy practice and research in the geriatric population

Efficacy of Electroconvulsive Therapy for the Treatment of Movement Disorders: A Literature Review

Recognition and Management of Antipsychotic-Induced Parkinsonism in Older Adults: A Narrative Review

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