Adverse events to antiparkinsonian medications in parkinsonian and non-parkinsonian patients.

SANTIAGO PEREZ-LLORET; VERÓNICA REY; NELLY FABRE; FABIENNE ORY-MAGNE; UMBERTO SPAMPINATO; JEAN-LOUIS MONTASTRUC; OLIVIER RASCOL

Toronto, Canada

Congreso; Congreso Internacional de Movimientos Anormales; 2011

Objective: To explore the gap in the frequency of AEs to antiparkinsonian medications in PD and non-PDpatients when explored by means of a full extensive questionnaire or by the patients´ spontaneous disclosure.Background: Less than 50% of Parkinson´s Disease (PD) patients reports spontaneously their non-motorsymptoms.Methods: Ambulatory non-demented, non-operated PD outpatients or patients who hada recovered fromstroke (both groups recruited at Toulouse University hospital) were initially asked to disclose any unpleasanteffect in connection with their medication during the last week. Afterwards, they were systematicallyquestioned about the presence of a predefined list of common AEs to L-DOPA, dopamine agonists, MAO-Binhibitors, COMT inhibitors, amantadine or antimuscarinics. ADR severity was assessed by the usualpharmacovigilance scale (mild/moderate/severe). A complete medical and medication history was conducted.PD severity was evaluated by the UPDRS scale.Results: 203 PD patients and 44 non-PD were recruited (mean age: 69 2 vs 67 1 y, p=0.3; males: 55% vs62% p=0.4). In PD, mean disease duration was 9 1 years, mean UPDRS II+III in ON-state was 37 2 . Six %of the PD patients received antimuscarinics, 8% a MAOB-Inhibitor, 15% amantadine, 23% COMT-I, 80% anagonist and 90% levodopa. Overall, one or more AEs were reported by 100% PD patients vs 93% non-PD usingthe structured questionaire (p<0.01). Fatigue, dry mouth, nausea/vomiting, constipation, neuropsychatricsymptoms (i.e hallucinations, delusions, confusion, memory loss, depression, anxiety, somnolence or disturbedsleep) or dry skin were more frequent in PD patients (all p<0.05). Only 42% of PD reported their AEsspontaneously, a figure that was essentially similar for all AEs. AEs´ spontaneous disclosure was related toshorter disease duration (OR=0.4, 0.2-0.8) and to experiencing > 2 AEs (3.2, 1.4-7.1), but not to ADRs´severity (logistic regression).Conclusions: All PD patients reported at least one AE using a structured questionaire. The gap between AEsidentified using the questionnaire or by spontaneous patients´ report was 58%, thus suggesting that apro-active attitude towards the search of AEs should be adopted.