SynthesisJournal of geriatric psychiatry and neurology2022
Orthostatic Hypotension and Antiparkinsonian Drugs: A Systematic Review and Meta-analysis.
Synthesis in Journal of geriatric psychiatry and neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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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.
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Who cites it
18 citing papers in PubMed, 20 citations in OpenAlex.
- Effect of levodopa on postural blood pressure changes in Parkinson disease: a randomized crossover study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Trial
- Frailty in Parkinson's disease: time to integrate it into treatment decision-making?Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Cardiovascular pharmacology of dopaminergic agents in humans: a review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Consensus expert recommendations for referral of Parkinson's disease patients for deep brain stimulation surgery.NPJ Parkinson's disease · 2026Review
- Stage-dependent clinical burden in hospitalized Parkinson's disease with a positive bedside orthostatic hypotension screen: a retrospective cross-sectional analysis.Frontiers in aging neuroscience · 2026Article
- Comorbidity and medication patterns in atrial fibrillation patients: association with adverse clinical outcomes.Internal and emergency medicine · 2025Article
- Association Between Levodopa with Inotrope Prescription and Mechanical Ventilation Dependence in People with Parkinson's Disease upon Septic Shock.Journal of clinical medicine · 2025Article
- Neurogenic Orthostatic Hypotension in Parkinson Disease-A Narrative Review of Diagnosis and Management.Journal of clinical medicine · 2025Review
- Identification of potentially causative drugs associated with hypotension: A scoping review.Archiv der Pharmazie · 2025Article
- Autonomic dysfunction in progressive supranuclear Palsy: A retrospective study.Clinical parkinsonism & related disorders · 2025Article
- Exploring Cardiovascular Autonomic Function before and after Chronic Deep Brain Stimulation in Parkinson's Disease.Movement disorders clinical practice · 2024Article
- Levodopa-induced orthostatic hypotension in parkinsonism: A red flag of autonomic failure.European journal of neurology · 2024Article
- Chronotropic Incompetence During Exercise Testing as a Marker of Autonomic Dysfunction in Individuals with Early Parkinson's Disease.Journal of Parkinson's disease · 2024Article
- Orthostatic hypotension and subjective symptomatic orthostasis in Parkinson's disease: Associations and correlations.Clinical parkinsonism & related disorders · 2024Article
- Beyond the Dopaminergic System: Lessons Learned from levodopa Resistant Symptoms in Parkinson's Disease.Movement disorders clinical practice · 2023Article
- Orthostatic Hypotension in Parkinson Disease: What Is New?Neurology. Clinical practice · 2022Article
- Epidemiology of autonomic dysfunction in Parkinson's disease (Review).Medicine internationalReview
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundOrthostatic hypotension (OH) is multifactorial in Parkinson's disease (PD). Antiparkinsonian medication can contribute to OH, leading to increased risk of falls, weakness and fatigue.
methodsWe conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of antiparkinsonian drugs associated with OH as an adverse effect, compared to placebo. We searched EMBASE, MEDLINE and Web of Science databases until November 2020. Analysis used fixed-effects models and the GRADE tool to rate quality of evidence. Meta-analysis was performed if 3 or more studies of a drug group were available.
resultsTwenty-one RCTs including 3783 patients were included comparing 6 PD drug groups to placebo (MAO-B inhibitors, dopamine agonists, levodopa, COMT inhibitors, levodopa and adenosine receptor antagonists). OH was recorded as an adverse event or measurement of vital signs, without further specification on how this was defined or operationalised. Meta-analysis was performed for MAO-B inhibitors and dopamine agonists, as there were 3 or more studies for these drug groups. In this analysis, compared with placebo, neither MAO-B inhibitors or dopamine agonists were associated with increased risk of OH, (OR 2.28 [95% CI:0.81-6.46]), (OR 1.39 [95% CI:0.97-1.98]).
conclusionsMost studies did not specifically report OH, or reporting of OH was limited, including how and when it was measured. Furthermore, studies specifically reporting OH included participants that were younger than typical PD populations without multimorbidity. Future trials should address this, for example,, by including individuals over the age of 75, to improve estimations of how antiparkinsonian medications affect risk of OH.
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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.