Clinical Spectrum of Drug-Induced Movement Disorders: A Study of 97 Patients

Tremor Other Hyperkinet Mov (N Y). 2020 Oct 26:10:48. doi: 10.5334/tohm.554.

Abstract

Background: Drug-induced movement disorders (DIMDs) are commonly encountered, but an often-under-reported subgroup of movement disorders.

Objectives: We aimed to highlight the spectrum of DIMDs in patients taking different groups of drugs at our movement disorder center.

Methods: It is a cross-sectional descriptive study including 97 consecutive DIMDs patients diagnosed over the past two years (2017-2019).

Results: The mean ± standard deviation (SD) age of our study population was 35.89 ± 17.8 years (Range-2-80 years). There were 51 males and 46 females. Different DIMDs observed included tardive dystonia (n = 41; 42.2%), postural tremor (n = 38; 39.2%), parkinsonism (n = 32; 33%), tardive dyskinesia (n = 21; 21.6%), acute dystonia (n = 10; 10.3%), neuroleptic malignant syndrome (NMS) (n = 2; 2.1%), and others [(n = 10; 10.30%) including chorea and stereotypy each in 3; acute dyskinesia in 2; and myoclonic jerks and acute akathisia each in 1 patient]. Of these 97 patients, 49 had more than one type of DIMDs while 48 had a single type of DIMDs. In our study 37 (38%) patients had received non-dopamine receptor blocking agents (non-DRBA), 30 (31%) patients had received dopamine receptor blocking agents (DRBA), and 30 (31%) patients had received both DRBA and non-DRBA.

Conclusions: Tardive dystonia was the most common DIMDs observed in our study. Our DIMDs patients were younger than other reported studies. We observed a significant number of non-DRBA drugs causing DIMD in our study as compared to previous studies. Drug-induced parkinsonism (DIP) was the most common DIMDs in the DRBA group. Tardive dystonia was the most common DIMDs seen in DRBA + non-DRBA group and the second most common in the DRBA and non-DRBA group. The postural tremor was the most common DIMDs in the non-DRBA group.

Keywords: Drug-induced movement disorder; Tardive syndromes; dopamine receptor blocker agents.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticonvulsants / adverse effects
  • Antidepressive Agents / adverse effects
  • Antiemetics / adverse effects
  • Antimanic Agents / adverse effects
  • Antineoplastic Agents / adverse effects
  • Antipsychotic Agents / adverse effects*
  • Child
  • Child, Preschool
  • Chorea / chemically induced
  • Cohort Studies
  • Dopamine Antagonists / adverse effects*
  • Dyskinesia, Drug-Induced / etiology*
  • Dyskinesia, Drug-Induced / physiopathology
  • Dystonia / chemically induced
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Myoclonus / chemically induced
  • Neuroleptic Malignant Syndrome / etiology
  • Parkinsonian Disorders / chemically induced
  • Stereotypic Movement Disorder / chemically induced
  • Tardive Dyskinesia / chemically induced
  • Tremor / chemically induced
  • Young Adult

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Antiemetics
  • Antimanic Agents
  • Antineoplastic Agents
  • Antipsychotic Agents
  • Dopamine Antagonists
  • Hypnotics and Sedatives