Valproate induced Parkinsonism
Valproate induced Parkinsonism
Keywords:
Secondary Parkinsonism, Valproate, Adverse drug reaction, Causality Assessment, Preventable.Abstract
Drug induced Parkinsonism is common with neuroleptics drugs, antiemetic drugs but it is uncommon with antiepileptic drug such as Valproate (VAL). Neurological adverse effects of VAL are ataxia, tremor, sedation, lethargy, confusion, and more rarely encephalopathy and coma, have rarely been reported. Very rare cases of VAL induced Parkinsonism features associated with cerebral atrophy have been reported. The mechanism of these is currently unknown, but several hypotheses have been proposed. Possible mechanism can be, in vitro VAL can stimulate the activity of the GABA and Glutamate which can lead to Parkinsonism feature. Hence we reported a case of Parkinsonism developed after 6months of VAL treatment and also recovered after withdrawal of VAL. [ Patel S Natl J Integr Res Med, 2018; 9(6):72-74]
References
2. .Easterford K, Clough P, Kellett M, Fallon K, and Duncan S.Reversible Parkinsonism with normal β-CIT-SPECT in patients exposed to sodium VAL. Neurology.2004April; 62(8):1435–1436.
3. Sean C Sweet man. Martindale the Complete Drug Reference.36thed.London: Pharmaceutical Press;2009 Antiepileptics;P.508
4. Geeta A Khwaja.VAL-induced Reversible ‘Parkinsonism Plus’ Syndrome.JIACM. 2010 July-September; 11(3): 235-8.
5. James O. McNamara. Goodman & Gilman’s The Pharmacological Basis of Therapeutics.12thed.New Delhi: McGraw-Hill; 2011.Chapter21, Pharmacotherapy of the Epilepsies;P.597.
6. David G. Standaert, Erik D. Roberson.Goodman& Gilman’s The Pharmacological Basis of Therapeutics.12thed.New Delhi: McGraw-Hill; 2011.Chapter22, Treatment of central nervous system degenerative disorders;P.613.
7. 7.SassoE,DelsoldatoS,NegrottiA,Mancia D. Reversible VAL-induced extrapyramidal disorders. Epilepsia 1994 March-April; 35(2): 391-3
8. Masmoudi K, Gras–Champel V, Masson H, Andrejak M. Parkinsonism and/or cognitive impairment with valproic acid therapy: a report of ten cases. Pharmacosychiatry 2006 Jan;39(1): 9-12.
