The Effect of Clozapine on Tremor in Patients with Parkinson’s Disease who were Initiated Clozapine For Psychotic Symptoms

Abstract

Aim: Tremor is one of the initial symptoms of Parkinson’s disease and most of the patients suffer from it along the course of the disease. Levodopa and dopamine agonists are used as first-line therapy. Studies showed that clozapine can be effective on patients who are resistant or insufficiently responsive to these therapies. In this retrospective study, we searched the effect of clozapine on tremor. Methods: We retrospectively analyzed the medical records of patients who have been followed in our Movement Disorders Clinic between the years 2005 and 2012. Fourteen patients using clozapine due to psychotic symptoms were included in the study. The patients were assessed using the Unified Parkinson’s disease rating scale (UPDRS) at the beginning and after 2 months of constant dose of clozapine usage. Two patients were excluded from the study because of non-compliance with the treatment due to excessive sedation. Assessments were done on 12 patients. Results: When the UPDRS scores before and after clozapine treatment examined, a statistically significant decrease was found in UPDRS-total, UPDRS-tremor, UPDRS-motor, and UPDRS-activities of daily living tremor scales after treatment. Conclusion: Since clozapine may have a positive effect on tremor in Parkinson’s disease, it can be considered as a treatment option for treatment-resistant psychotic symptoms. (The Medical Bulletin of Haseki 2013;51:173-7)

Keywords

• Parkinson’s Disease
• clozapine
• tremor