Trends in the Prevalence of Drug-Induced Parkinsonism in Korea

Abstract

Purpose Discontinuation of offending drugs can prevent drug-induced parkinsonism (DIP) before it occurs and reverse or cure it afterwards. The aim of this study was to investigate the prevalence of DIP and the utilization of offending drugs through an analysis of representative nationwide claims data. Materials and Methods We selected DIP patients of ages ranging from 40 to 100 years old with the G21.1 code from the Korean National Service Health Insurance Claims database from 2009 to 2015. The annual standardized prevalence of DIP was explored from 2009 to 2015. Trends were estimated using the compound annual growth rate (CAGR) and the Cochran-Armitage test for DIP over the course of 6 years. Additionally, the utilization of offending drugs was analyzed. Results The annual prevalence of DIP was 4.09 per 100000 people in 2009 and 7.02 in 2015 (CAGR: 9.42%, p <0.001). Levosulpiride use before and after DIP diagnosis showed a clear trend for decreasing utilization (CAGR: −5.4%, −4.3% respectively), whereas the CAGR for itopride and metoclopramide increased by 12.7% and 6.4%, respectively. In 2015, approximately 46.6% (858/1840 persons) of DIP patients were prescribed offending drugs after DIP diagnosis. The most commonly prescribed causative drug after DIP diagnosis was levosulpiride. Conclusion The prevalence of DIP has increased. To prevent or decrease DIP, we suggest that physicians reduce prescriptions of benzamide derivatives that have been most commonly used, and that attempts be made to find other alternative drugs. Additionally, the need for continuing education about offending drugs should be emphasized.

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

“…This study found the incidence of DIP to have increased in older age and in women, but to have decreased overall in that period due to changes in the prescription of APs [9]. Other studies have, however, provided evidence for an overall increase in the annual prevalence of DIP; for example, from 4.09/100,000 in 2009 to 7.02/100,000 in 2015 in a South Korean study [10], which was mainly caused by the use of benzamide derivatives for gastrokinetic indications. See Table 1a,b for the relevant epidemiological studies.…”

“…See Table 1a,b for the relevant epidemiological studies. Most published studies in community or general population settings have reported DIP to be the second (or less frequently third) most common cause of parkinsonism after IPD, especially in the older population, ranging from 2% to 76% of all cases of parkinsonism [5,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. However, when a large database of over 20000 cases of druginduced side-effects over a 17-year period was examined in one French study, the rate of DIP was found to be of 0.7% [26].…”

The Hidden Cost of the Opioid Epidemic in the United States: Drug Screening in Insurance Claims

“…All graphs of the data were generated using KaleidaGraph 4.5 (Synergy Software, Reading, PA). To further describe testing trends, the compound annual growth rate (CAGR) 23 , 24 was determined using Equation 1 below, where V f , V i , and t represent the final value (in number of claims), initial value (in number of claims), and time (in years), respectively: …”

Risks of Sulpiride-Induced Parkinsonism in Peptic Ulcer and Gastroesophageal Reflux Disease Patients in Taiwan: A Nationwide Population-Based Study

“…The extrapyramidal manifestations caused by sulpiride include dystonia, akathisia, parkinsonism, and tremor (Eapen et al, 1993;Mauri et al, 1996;Lai et al, 2014). Recently, two big data-based studies and one meta-analysis have focused on drug-induced parkinsonism (DIP) (Martino et al, 2018;Byun et al, 2019;Kim et al, 2019). The first population-based study concluded that use of propulsives and antipsychotics including sulpiride had a significant association with the increased risk of DIP, depending on recency and cumulative dose (Kim et al, 2019).…”

“…The first population-based study concluded that use of propulsives and antipsychotics including sulpiride had a significant association with the increased risk of DIP, depending on recency and cumulative dose (Kim et al, 2019). Another population-based research found that annual prevalence of DIP has increased, and the usage of specific offending medications is the major cause (Byun et al, 2019). In the meta-analysis study focused on second-generation antipsychotics, the prevalence estimates are of 15.3% for acute dystonia, 16.4% for akathisia, 29.3% for parkinsonism, and 28.2% for tremor induced by sulpiride (Martino et al, 2018).…”