Naslov
Clozapine in the treatment of drug-resistant tremor in Parkinson's disease: Double-blind study

Autori
Relja, Maja ; Telarović, Srđana

Izvornik
Movement disorders (0885-3185) 17 (2002), Suppl. 5;

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

Sažetak
Objective: To evaluate the efficacy and safety of clozapine in the treatment of drug-resistant tremor in Parkinson's disease (PD) patients. Background: Tremor is a classic symptom of PD that is only weakly responsive to levodopa and/or anticholinergic therapy. Clozapine is an atypical antipsychotic with very weak extrapyramidal side effects. Several open studies have shown that clozapine can ameliorate dyskinesias and tremor in PD. Design/Methods: Patients Patients with idiopathic PD and disabling tremor resistant to dopaminergic medication were enrolled in the 3-month duration study. All patients were treated with levodopa, dopamine agonists, selegiline and/or amantadine Study design Double-blind, cross-over, randomized study. All patients (after given an informed consent) were randomized to receive anticholinergic medication, clozapine and/or placebo during 30 days. There was no wash-out between treatment periods. The dosage of clozapine (Leponex 25-50 mg/daily) and/or anticholinergic drug (biperiden 5-10 mg daily) was gradually increased during one week. Methods Clinical assessment at weekly bases was performed using the Unified Parkinson's Disease Disability Rating Scales (UPDRS: motor and tremor score) and quantitative recording of tremor using biaxial accelerometry. The values obtained from both hands (sum of right and left) were used for statistical analysis. Adverse events (with blood counts) were recorded. Statistical analysis The Wilcoxon matched pairs test and Friedman analysis were used for statistical evaluation. Only p values below 0.05 were considered significant. Results: Our results shown that both clozapine and anticholinergic drug biperiden significantly (p<0.05) reduced tremor in PD patients . However, statistical analysis revealed that clozapine therapy was more potent than anticholinergics (p<0.05) in reducing tremor as assessed using the biaxial accelometry and UPDRS . Clozapine treatment showed improvement of dyskinesias. There was no blood cell count change and no serious side-effect during the study (mild sedation in some patients during the first week of clozapine treatment). Conclusion: On the basis of our study, clozapine can be used safely in PD patients with disabling drug-resistant tremor.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Poster session 7: Ataxia, chorea, drug-induced movement disorders, myoclonus, spasticity, stereotypies, tics, tremor (p S311-S355) Published Online: 21 Oct 2002 DOI: 10.1002/mds.10355

POVEZANOST RADA