ReviewMovement disorders clinical practice
Clozapine in Parkinsonian Rest Tremor: A Review of Outcomes, Adverse Reactions, and Possible Mechanisms of Action.
Review in Movement disorders clinical practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 43 citations in OpenAlex.
- Tremor management strategies in Parkinson's disease: optimizing patient care.Neurodegenerative disease management · 2026Review
- Clozapine for Parkinson's disease psychosis in a septuagenarian: a nightmare turned into bliss.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Clozapine for Quetiapine-Refractory Psychosis in Parkinson's Disease: A Long-Term Single-Center Retrospective Study.Parkinson's disease · 2025Article
- Clinicians' viewpoints on current paradigms of care and research in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Anticholinergic drugs for parkinsonism and other movement disorders.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Pharmacotherapy of motor symptoms in early and mid-stage Parkinson's disease: guideline "Parkinson's disease" of the German Society of Neurology.Journal of neurology · 2024Article
- Tips and tricks in tremor treatment.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug.Brain sciences · 2024Review
- The Clinical Profile of Tremor in Parkinson's Disease.Movement disorders clinical practice · 2023Article
- Pharmacological Treatment of Tremor in Parkinson's Disease Revisited.Journal of Parkinson's disease · 2023Review
- An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson's Disease.Current neuropharmacology · 2023Review
- Clozapine Is Severely Underused in Parkinson's Disease Patients.Movement disorders clinical practice · 2022Article
- Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions.Journal of Alzheimer's disease : JAD · 2022Review
- Tremor in Parkinson's Disease: From Pathophysiology to Advanced Therapies.Tremor and other hyperkinetic movements (New York, N.Y.) · 2022Review
- Acupuncture Alleviates Levodopa-Induced Dyskinesia via Melanin-Concentrating Hormone in Pitx3-Deficient aphakia and 6-Hydroxydopamine-Lesioned Mice.Molecular neurobiology · 2019Article
- Emerging therapies in Parkinson disease - repurposed drugs and new approaches.Nature reviews. Neurology · 2019Review
- Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly.Drugs & aging · 2018Review
- Clozapine-Induced Cardiomyopathy in Parkinson's Disease.Movement disorders clinical practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe pathogenesis of rest tremor in Parkinson's disease (PD) is incompletely understood. This symptom can be resistant to typical anti-PD medications. Therefore, new treatments are needed given the concern that this symptom causes to patients and family. Limited experience suggests that clozapine can have an important antitremor effect in PD. The mechanism(s) underlying this effect is not well understood, but could provide insight and impetus to the development of more-effective and safer antitremor therapies. METHODS AND
resultsExemplifying the antitremor effects of clozapine, we describe a patient with tremor-predominant PD who obtained prominent reduction of rest tremor with clozapine treatment. We review the responses to this treatment in another 7 of our PD patients with treatment-resistant rest tremor. We also review the published literature on clozapine for tremor in PD and discuss its potential mechanisms of action and possible adverse effects. In our case series, there was a 64% reduction of tremor score after clozapine was initiated. The mechanism of tremor reduction remains unclear with possible involvement of anticholinergic, serotonergic, antihistaminergic, antiadrenergic, and antidopaminergic effects. Clozapine does have potential serious adverse effects.
conclusionsClozapine may be effective in controlling rest tremor in PD. Given the potential fatal side effects, if clozapine is to be initiated in PD patients, it has to be used cautiously with proper monitoring, preferably in specialized centers. We acknowledge that the number of patients in this case series is small. Further studies are needed to understand clozapine's mechanism of action in reducing tremor.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.