Study: Psychotropic Medication Use in Parkinson's Disease

A long-term study from the University of Eastern Finland has tracked psychotropic medication use among people with Parkinson's disease over a ten-year period, comparing them to a matched control group. The research provides a clear picture of how the use of these medications evolves before and after a Parkinson's diagnosis.

Up to one in three people with Parkinson's disease use at least one psychotropic medication.

The study included 17,370 community-dwelling individuals with Parkinson's disease and 115,386 matched controls without the disease. The research period covered five years before diagnosis to five years after diagnosis, offering a comprehensive longitudinal view.

Key Findings on Medication Use

People with Parkinson's disease used psychotropics more frequently than controls before diagnosis, with use increasing as the disease progressed.

• The proportion using a single psychotropic medication increased from 18% to 35% among Parkinson's patients, compared to an increase from 14% to 20% among controls.
• Use of medications from at least two different psychotropic groups was more common among Parkinson's patients, rising from 5% at the study's start to 10% at its end.
• Psychotropic use was most frequent in the oldest age group (80 years or older) in both cohorts.
• Benzodiazepines and related drugs were the most frequently used psychotropics in controls throughout the study and in Parkinson's patients up to three years after diagnosis, after which antidepressants became more common.

The Broader Context of Parkinson's Disease

Parkinson's disease is a progressive neurological disorder primarily characterized by motor symptoms such as resting tremor, slowness of movement, and rigidity. However, the disease often involves a range of other challenges.

The disease may involve neuropsychiatric symptoms, sleep disorders and pain even before motor symptoms appear, which are often treated with psychotropics.

According to the researchers, the more frequent psychotropic use among Parkinson's patients likely reflects the emergence of these non-motor symptoms before diagnosis and their worsening as the disease progresses.

An Important Note on Risk

The researchers highlighted a significant concern regarding medication safety. Psychotropic use, particularly polypharmacy, increases the risk of falls and related fractures in older people, while those with Parkinson's disease are already at increased risk for these events. This underscores the need for careful medication management in this patient population.