Naslov
Effects of atypical neuroleptic clozapine on resistant tremor in Parkinson disease

Autori
Telarović Srđana, Kostanjevec Ruža, Relja Maja

Izvornik
Neurologia Croatica (0353-8842) 50 (2001);

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, kongresno priopcenje, znanstveni

Sažetak
The need of research into the new and more efficient medicaments is imposed by the complex problem of managing tremor in Parkinson disease (PD). Therapeutic insufficiency has become even greater by the demonstration of direct connection between the presently most potent medicament for tremor reduction, ie anticholinergic biperiden, and development of some forms of dementia.The effect of the atypical neuroleptic clozapine was clinicaly compared with placebo and biperiden in patients who had been unsuccesfully treated with various antiparkinsonians, including anticholinergics. Tremor was evaluated after the use of placebo, clozapine and\or biperiden by two differnet but compatible and comparable methods, computed neurophysiological method of accelerometry and quantitative evaluation of tremor by the generally accepted Unified Parkinson Disease Rating Scale (UPDRS). The study was conducted as a double blind crossover placebo-controlled clinical trial at the Laboratory of Extrapiramidal Diseases and Clinical Neuropharmacologz, Zagreb University Hospital Center in Zagreb. Study results showed a statistically significant higher efficacy of cloyapine in tremor reduction as compared to either placebo or anticholinergic biperiden (Friedman nonparametric test for dependent patterns and Wilcoxon pair test). Accelerometry was found to be a simple, nonivasive, easly available, not too expensive and repeatable method characteriyed by diagnostic specificity, accuracy and both clinical and pharmacological sensitivity. On the basis of these results, along with careful patients selection, critical use and regular follow-up of various side effects, atypical neuroleptic clozapine appears to be the therapy of choice in the management of resistant tremor in PD patients. The study results contribute to the solution of the complex problem of inadequate tremor therapy and they also represent a starting point for additional studies of similar and other medicaments intended for the managment of tremor and other extrapyramidal disturbances.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA