Evidence map›Paper›PMID 34324057›Full record

SynthesisJournal of neural transmission (Vienna, Austria : 1996)2022

Implications of dopaminergic medication withdrawal in Parkinson's disease.

J Koschel, K Ray Chaudhuri, L Tönges, M Thiel, V Raeder, W H Jost

Open access · bronzeAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neural transmission (Vienna, Austria : 1996), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 12% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Visual Cues for Turning in Parkinson's Disease.Sensors (Basel, Switzerland) · 2022
    Article
  16. Article
  17. Review
  18. An updated calculator for determining levodopa-equivalent dose.Neurological research and practice · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

J KoschelParkinson-Klinik Ortenau, Kreuzbergstr. 12, 77709, Wolfach, Germany.
K Ray ChaudhuriBiomedical Research Centre, Institute of Psychiatry, Psychology and Neurosciences, King's College and Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK.
L TöngesNeurologische Klinik der Ruhr-Universität Bochum, Bochum, Germany.
M ThielParkinson-Klinik Ortenau, Kreuzbergstr. 12, 77709, Wolfach, Germany.
V RaederParkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK.
W H JostParkinson-Klinik Ortenau, Kreuzbergstr. 12, 77709, Wolfach, Germany. W.Jost@parkinson-klinik.de.ORCID 0000-0002-8574-3297
Parkinson-Klinik Ortenau · DEKing's College Hospital · GBKing's College Hospital NHS Foundation Trust · GBRuhr University Bochum · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The trajectory of the use of dopamine replacement therapy (DRT) in Parkinson's disease (PD) is variable and doses may need to be increased, but also tapered. The plan for dose adjustment is usually done as per drug information recommendations from the licensing bodies, but there are no clear guidelines with regards to the best practice regarding the tapering off schedule given sudden dose reductions of drugs such as dopamine agonists may have serious adverse consequences. A systematic literature search was, therefore, performed to derive recommendations and the data show that there are no controlled studies or evidence-based recommendations how to taper or discontinue PD medication in a systematic manner. Most of the data were available on the dopamine agonist withdrawal syndrome (DAWS) and we found only two instructions on how to reduce pramipexole and rotigotine published by the EMA. We suggest that based on the available data, levodopa, dopamine agonists (DA), and amantadine should not be discontinued abruptly. Abrupt or sudden reduction of DA or amantadine in particular can lead to severe life-threatening withdrawal symptoms. Tapering off levodopa, COMT inhibitors, and MAO-B inhibitors may worsen motor and non-motor symptoms. Based on our clinical experience, we have proposed how to reduce PD medication and this work will form the basis of a future Delphi panel to define the recommendations in a consensus.

Indexed as

DopamineParkinson DiseaseSubstance Withdrawal SyndromeAmantadineDopamine AgonistsHumansLevodopaAmantadineDopamineDopamine AgonistsLevodopaDopamine agonistsLevodopaParkinson’s diseaseSide effectsWithdrawal

Identifiers

PMID34324057
PMCPMC8319886
OpenAlexW3185203132

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.