Savers are well versed in the dangers of osteoporosis drugs. They are ineffective and worse, they actually can cause fractures instead of preventing them. But osteoporosis drugs are not the only dangerous prescription drugs, and they’re not the only ones that increase fracture risk.

Today we’ll look at Drug-Induced Parkinsonism (DIP), a form of Parkinson’s Disease (PD) that is caused by certain commonly prescribed drugs. Often, doctors misdiagnose this condition as regular Parkinson’s Disease and prescribe more drugs instead of ending treatment with the drug that’s causing it.

And in some cases, DIP may persist or even worsen after the patient stops taking the drug that induced DIP. We’ll look at studies about this condition and identify the drugs responsible for causing it. Then we’ll examine the implications for fracture risk and bone health.

Drug-Induced Parkinsonism

Drug-Induced Parkinsonism (DIP) is a form of parkinsonism, a progressive nervous system disorder characterized by tremor, rigidity, impaired balance, speech changes, and slowness of movement (bradykinesia) as well as loss of postural reflexes and freezing (the temporary, involuntary inability to move). DIP is the second most common form of parkinsonism after Parkinson’s Disease (PD), but the symptoms and effects are often the same, leading to frequent misdiagnosis of DIP as PD.1

The causes of PD are unknown, but the symptoms mostly result from abnormal brain activity caused by the loss of neurons that produce the chemical messenger dopamine. As mentioned earlier, DIP is caused by drugs that affect dopamine receptors, rendering the same set of symptoms as PD.2

A range of prescription drugs can cause DIP. The most common are antipsychotics called neuroleptics. However, some atypical antipsychotics and gastrointestinal (GI) motility drugs (antiemetics), calcium channel blockers (CCBs), and antiepileptic drugs can also induce DIP.2

Drugs that frequently cause DIP:

Typical Antipsychotics:

  • Phenothiazine: chlorpromazine, prochlorperazine, perphenazine, fluphenazine, promethazine
  • Butyrophenones: haloperidol
  • Diphenylbutylpiperidine: pimozide
  • Benzamide substitutes: sulpiride

Atypical Antipsychotics (dopamine):

  • Risperidone
  • Olanzapine
  • Ziprasidone
  • Aripiprazole

Dopamine Depleters

  • Reserpine
  • Tetrabenazine

Antiemetics:

  • Metoclopramide
  • Levosulpiride
  • Clebopride

Calcium-Channel Blockers:

  • Flunarizine
  • cinnarizine

Drugs that infrequently cause DIP:

Atypical Antipsychotics:

  • Clozapine
  • Quetiapine

Mood Stabilizers:

  • Lithium

Antidepressant:

  • Citalopram
  • Fluoxetine
  • Praoxetine
  • Sertraline

Antiepileptic drugs:

  • Valproic Acid
  • Phenytoin

Antiemetics:

  • Domperidone
  • Itopride

Synopsis

Drug-Induced Parkinsonism (DIP) is a form of parkinsonism caused by drugs that impact dopamine production and reception in the brain.

How To Avoid DIP

The incidence rate of DIP has proved difficult to assess, due to the prevalence of misdiagnosis as PD. Older people and women are at higher risk of DIP, and genetic factors may also play a role.2

The only way to develop DIP is by taking a prescription drug that impacts the brain’s dopamine system. If you don’t take those drugs, you cannot develop it.

Unfortunately, in some cases, DIP is misdiagnosed as PD. Researchers discovered that 6.8% of patients diagnosed with PD were later reclassified as having DIP.3 This mistake is particularly harmful since doctors may prescribe drugs to manage PD symptoms instead of stopping the drug that’s causing DIP.

Discontinuing the responsible drug most often ends DIP. However, in some cases, the symptoms persist. In others, the parkinsonism continues to worsen along a track consistent with PD. Researchers have postulated that in these cases the drugs unmasked PD, which may have otherwise gone unexpressed.

Synopsis

If you don’t take a prescription drug that causes DIP, then you cannot develop it. People experiencing DIP can usually end it by discontinuing the medication that caused it, but for some people, the symptoms persist or worsen.

Parkinsonism, Falls, And Fracture Risk

All forms of parkinsonism, both PD and DIP, have implications for bone health. A 2014 meta-analysis on PD and fracture risk concludes that PD increases the risk of fracture.4

Given that the symptoms of parkinsonism affect balance, motor skills, gait, and the body’s ability to control movement, it is no surprise that people with PD are more likely to experience a fall than people without PD. Here is an excerpt from a 2016 study comparing the incidence of falls and fracture in PD patients:

It is estimated that 60.5% of patients with PD experience at least one fall and 39% have recurrent falls. The high frequency of falls consequently contributes to the increased risk for fractures in PD patients, which has been estimated to be approximately two times the risk in healthy controls. It has been estimated that 76% of falls in PD patients require health care services and 33% result in fractures. Falls and fractures may result in a series of unfavorable outcomes, such as disabilities and death. Furthermore, among PD patients with fractures, the mortality rate is approximately 10.6%.5

All too often, doctors prescribe these drugs without appropriate consideration of this risk. This excerpt from a study on DIP clarifies the danger of accepting a prescription of an unnecessary or inappropriate prescription drug:

About 50% of patients with DIP and other movement disorders are treated with DRBAs for conditions unrelated to psychosis, including depression, GI disturbance, anxiety, and insomnia. Physicians should avoid prescribing DRBAs [dopamine receptor blocking agents] and CCBs [calcium channel blockers] for inappropriate reasons such as anxiety, insomnia, dizziness or dyspepsia in elderly patients and should monitor these patients’ neurological signs, especially parkinsonism and other movement disorders, when prescribing these drugs.2

Shockingly, the drugs that cause DIP are still being prescribed. This yet one more example further proving that the FDA’s drug approval process is useless.

Synopsis

Parkinsonism doubles fracture risk. Drugs that cause parkinsonism are approved by the FDA and prescribed by doctors.

Be Your Own Health Advocate

Every drug carries risks.The Save Institute recommends avoiding prescriptions drugs except in matters of life and death. The dire, life-altering consequences of DIP are a striking example of why this recommendation is so important for maintaining your health.

Do your own research about the potential side effects of any drug, and always seek a natural remedy instead of a synthetic drug. In the case of osteoporosis and osteopenia, reversal is possible through a combination of diet, exercise and bone-healthy lifestyle choices.

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References:

1 Maria Victoria G. Alvarez, Virgilio Gerald H. Evidente. “Understanding drug-induced parkinsonism.” Neurology Feb 2008, 70 (8) e32-e34. Web. http://n.neurology.org/content/70/8/e32

2 Hae-Won Shina, Sun Ju Chung. “Drug-Induced Parkinsonism.” J Clin Neurol. 2012 Mar; 8(1): 15–21. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325428/

3 Esper CD1, Factor SA. “Failure of recognition of drug-induced parkinsonism in the elderly.” Mov Disord. 2008 Feb 15;23(3):401-4. Web. https://www.ncbi.nlm.nih.gov/pubmed/18067180/

4 Li Tan, et al. Parkinson’s Disease and Risk of Fracture: A Meta-Analysis of Prospective Cohort Studies. PloS one.. April 8 2014. Web. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094379

5 Kalilani, Linda et al. “Comparing the Incidence of Falls/Fractures in Parkinson’s Disease Patients in the US Population.” PloS one vol. 11,9 e0161689. 1 Sep. 2016. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008740/

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19 comments. Leave Yours Now →
  1. Jane Garibay August 31, 2019, 11:50 am

    I have been diagnosed with osteoporosis in my left femur. Dr wants me to take florax. Why would I take it if it causes fractures when I already have a weak femur. So scaref

  2. Cathy English July 12, 2019, 7:17 am

    Three months of Forteo and I fell resulting in two pelvic fractures… EXTREMELY difficult to walk now…

  3. jael schwab March 7, 2019, 7:49 pm

    I placed an order for the Osteo Cleanse. I gave my info for payment, but didn’t ask for my address. How will you delivered to me? Thanks.

  4. June from down under February 26, 2019, 4:30 am

    Could you please send me the link with information on Prolia so that I can send it to my relative in the US. I have requested this before but have not heard from you as yet. Just read the frightening experience from Helen on this page. My heart goes out to her and all of the others who are unaware of what they are taking and what it is doing to their bodies. Trying to avoid a hip replacement by taking Prolia which actually in Helen’s case caused the hip replacement, I find this quite alarming. Big Pharma just replaces the faulty drugs with a new name and gets away with it.

    Hoping that you can get back to me soon, thanks Vivian and staff.

  5. KimiW February 17, 2019, 10:52 am

    As usual, many thanks to Ms. Vivian for keeping us SoB’ers in the loop on not only the how’s but also the how-not’s in managing our health as it pertains to our structure and all that builds AND erodes. My last usually-scary osteoporosis counts came in as upper-end osteopenia ~ a first-ever as my scans and tests had never not indicated at least a 10-20% worsening since initial diagnosis 2 decades ago. Knock on wood here but I’ve also suffered no hip or rib fractures, and very seldom osteo-arthritic pain (comparatively) since I stopped my meds. I’m thrilled to ever have found you and your wonderful program so THANK YOU for all of that. ?

  6. Babs Robertson February 16, 2019, 2:00 pm

    I have to take 1or2 of those medications due to having epilepsy.

  7. Loraine February 15, 2019, 12:30 am

    Thanks Vivian. Some new doctors will insist on giving a drug even though you show a severe allergy (blood pressure meds. ) I have refused to take it. I also ask my pharmacist for instructions on contents of newly ordered Rx. Seems drug pushing is number one.

  8. Mary February 14, 2019, 10:15 pm

    Thanks Vivan, keep up the good work for us all.
    In other words Vivian, almost all the antipsychotics and any drugs that act on the central nervous system as well as lots of others, do untold damage. And big Pharma is still allowed to concoct & push them all freely.
    As an ex pharmacist, I take none of them, having seen so much damage over the years.

  9. shulamit sendowski February 14, 2019, 3:39 pm

    Thank you for the drug-list.

    • Vivian Goldschmidt, MA February 14, 2019, 6:34 pm

      You’re welcome!

  10. Linda F. February 14, 2019, 2:17 pm

    Because I have Epilepsy [ have been on medication for over 50 years. I have Osteoporosis because one of the medications I was taking was Tegretol. So I am told by a nurse that it causes bone thinning over the years.

  11. Ita February 14, 2019, 1:47 pm

    Thank you, Ita.

    • Vivian Goldschmidt, MA February 14, 2019, 2:09 pm

      You’re very welcome, Ita!

  12. Marie February 14, 2019, 1:07 pm

    One of the blood pressure medications I have been taking has been recalled. I do not want to take prescription medication. Can you suggest a natural remedy.

  13. Evelyn hastings February 14, 2019, 12:38 pm

    It would be helpful if the drug names were names easily recognized in this article about Parkinson’s. I might be taking one of these, but have no clue. Thanks.

    • Save Institute Customer Support February 14, 2019, 2:14 pm

      Evelyn, an online search of the medicine you’re taking will give you its generic name. Then you can refer back to this article. If you need more help with this, please don’t hesitate to send an email to support@saveinstitute.com.

  14. Helen S. February 14, 2019, 9:03 am

    I also wanted to forewarn about drugs like Prolia, given often for osteoporosis. I received 2 6-mths apart injections of it and developed a femur fracture, which became bone necrosis, which then collapsed, requiring hip replacement surgery. This type of drug should be taken off the market as it is very dangerous, and there are no warnings about it manufacture information or from doctors!

    • Vivian Goldschmidt, MA February 14, 2019, 9:41 am

      We are sorry that you are yet one more victim of osteoporosis drugs, Helen! And we wholeheartedly agree with you: they should be taken off the market. We hope you’ve had a full recovery from the hip replacement surgery and wish you all the best.

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