Drug-induced parkinsonism in the elderly

Drug-induced parkinsonism is primarily caused by drugs that interfere with dopamine stimulation. Antipsychotic drugs are the most common offenders, but drug-induced parkinsonism may be seen with many other drugs, such as antiemetics and certain calcium-channel blockers. These medications are widely used in the elderly. Unlike the first generation of antipsychotic drugs, all of which cause parkinsonism and other extrapyramidal side effects, atypical antipsychotics have motor side effects that are not uniform. Among the atypicals, only quetiapine and clozapine are not associated with drug-induced parkinsonism. Since drug-induced parkinsonism is frequently under-recognized, it may be devastating in an elderly person with already compromised gait.