UMEM Educational Pearls

Category: Toxicology

Title: Drug Induced Parkinsonism

Keywords: manganese, parkinsons, tremor (PubMed Search)

Posted: 12/17/2009 by Fermin Barrueto, MD (Updated: 8/21/2019)
Click here to contact Fermin Barrueto, MD

Here is a table adapted from Goldfrank's Textbook of Toxicologic Emergencies 8th Edition - Drugs that May Induce Parkinsonism. MPTP is the story that everyone hears about and actually has links to Maryland. In 1976, Barry Kidston, a 23-year-old chemistry Maryland graduate student, synthesized MPPP (Meperidine or Demerol) incorrectly and injected the result. It was contaminated with MPTP, and within three days he began exhibiting symptoms of Parkinson's disease. Ooops - permanent.

Reversible

  • Chemotherapeutics (several)
  • Cyclosporine
  • Calcium Channel Blockers
  • Dopaminergic withdrawal
  • Kava Kava (with manganese)
  • Progesterone
  • Sertraline
  • Valproic Acid
  • Trazodone

Irreversible

  • Carbon Monoxide
  • Cyanide
  • Heroin
  • Manganese
  • MPTP