3/14/23, 7:54 PM A STUDY OF CLINICAL SPECTRUM, RISK FACTORS AND OUTCOME OF DRUG-INDUCED MOVEMENT DISORDERS - …

A STUDY OF CLINICAL SPECTRUM, RISK FACTORS

AND OUTCOME OF DRUG-INDUCED MOVEMENT
DISORDERS
R. Anand, S. Pandey, HS. Malhotra, RK. Garg, N. Kumar, R. Uniyal, I. Rizvi (Lucknow, India)
Meeting: 2022 International Congress
ABSTRACT NUMBER: 508
Keywords: Drug-induced parkinsonism(DIP), Tardive akathisia, Tardive dyskinesia(TD)

Category: Drug-Induced Movement Disorders

Objective: We aimed to characterize the spectrum of DIMDs, and the culprit agents commonly encountered
in the movement disorder clinic. We also set out to study the response to therapy, and the impact on the
quality of life.

Background: Drug-induced movement disorders (DIMDs) form an important treatable subgroup of

movement disorder, which despite conferring a significant iatrogenic burden tend to be under-recognized
and inappropriately managed. DIMDs are cause by dopamine D2 receptor blocking agents which include not
only the first- and second-generation antipsychotics, but also certain antiemetic and prokinetic agents.

Method: It is a prospective cohort study, conducted from 2020-22 including 55 consecutive DIMDs patients
presenting to our movement disorder clinic.  Patients were assessed using UPDRS, UDRS, BARS, and AIMS
clinical rating scale at presentation and at six months. The quality of life was assessed using EuroQol(EQ-5D-
5L).

Results: Out of 55 patients, 14(25.45%) had Acute/subacute DIMD and 41(74.55%) had chronic DIMD.
Chronic DIMD occurred more commonly in the elderly age group (50.73±16.92) years compared to the
acute/subacute group (35.28±19.04) (p=0.006). The most common movement disorders in acute-subacute
DIMD was dystonia (42.86%) followed by parkinsonism(35.71%) whereas parkinsonism(39.02%) was
frequent in chronic DIMD followed by tardive dyskinesia(29.27%). The class of drugs most commonly
implicated were antipsychotics(38.46%) followed by prokinetic agents(33.85%). DIMDs in 13(23.64%)
patients were caused by two or more offending agents. The mean duration of exposure was 5.33 days in
acute/subacute DIMDs and 275.34 days(~39 wks2 days) in patients with tardive DIMD. Patients with
acute/subacute DIMDs showed significant improvement in severity scales(p<0.05). Patients with tardive
DIMD showed significant improvement in UPDRS and AIMS scales(p<0.05). Quality of life scales showed
significant improvement in perceived health though patients with tardive DIMDs failed to return to the
premorbid state.

Conclusion: In addition to anti-psychotic agents we observed a significant number of prokinetic agents

causing DIMDs as compared to previous studies. We also observed that more than one movement disorder
can co-exist and more than one offending agent may be responsible for the causation, thereby making it
challenging for the clinician to identify the culprit agent in the early stages, when it may be reversible.

To cite this abstract in AMA style:

R. Anand, S. Pandey, HS. Malhotra, RK. Garg, N. Kumar, R. Uniyal, I. Rizvi. A STUDY OF CLINICAL
SPECTRUM, RISK FACTORS AND OUTCOME OF DRUG-INDUCED MOVEMENT DISORDERS

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3/14/23, 7:54 PM A STUDY OF CLINICAL SPECTRUM, RISK FACTORS AND OUTCOME OF DRUG-INDUCED MOVEMENT DISORDERS - …

[abstract]. Mov Disord. 2022; 37 (suppl 1). https://www.mdsabstracts.org/abstract/a-study-of-clinical-

spectrum-risk-factors-and-outcome-of-drug-induced-movement-disorders/. Accessed March 14, 2023.

MDS Abstracts - https://www.mdsabstracts.org/abstract/a-study-of-clinical-spectrum-risk-factors-and-

outcome-of-drug-induced-movement-disorders/

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