DRUG-INDUCED PARKINSONISM: CLINICAL PREDICTORS, DIFFERENTIAL DIAGNOSIS, THERAPEUTIC ALGORITHMS
Keywords:
drug-induced parkinsonism, antipsychotics, extrapyramidal disorders, amantadine, differential diagnosisAbstract
Objective. Systematization of data on drug-induced parkinsonism (DIP) to optimize diagnostic and treatment algorithms in neurological and psychiatric practice. Methods. An analytical review of modern clinical studies and guidelines for 2020–2025 regarding the epidemiology, pathogenesis, and therapy of DIP was conducted. Results. DIP ranks second among the causes of parkinsonism in the elderly. The main inducers are typical antipsychotics and calcium channel blockers (cinnarizine, flunarizine). Key criteria for differentiating DIP from Parkinson's disease (PD) were identified: symmetry of symptoms, subacute course, and lack of progression after drug withdrawal. The efficacy of amantadine as a first-line drug for DIP correction in elderly patients was confirmed due to a safety profile superior to anticholinergics. Conclusion. Timely identification of DIP and modification of pharmacotherapy (dose de-escalation, rotation of antipsychotics) allow for complete regression of symptoms in 75–85% of cases.
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