Evidence map›Paper›PMID 38523545›Full record

ArticleCurrent drug safety2025

Dopaminergic Drugs and Valproate-associated Refractory Hyponatremia Over Levosulpiride-induced Parkinsonism in an Elderly Female Patient When Deprescribing was the Only Therapy.

Amol Dehade, Sankha Shubhra Chakrabarti, Noti Taruni Srija Reddy, Upinder Kaur

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Current drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Pooled it
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

4 authors at 2 institutions in 1 country.

Amol DehadeDepartment of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.
Sankha Shubhra ChakrabartiDepartment of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.
Noti Taruni Srija ReddyInstitute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.
Upinder KaurDepartment of Pharmacology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India.
Banaras Hindu University · INInstitute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrescribing cascade is a condition in which a drug administered to a patient causes an adverse reaction that is misinterpreted as a new condition, resulting in the addition of a new drug. CASE PRESENTATION: Here, we report the case of an elderly female patient who suffered from metabolic, neurologic, and urinary consequences of a prescribing cascade of antiemetic, antiepileptic, and dopaminergic drugs. While levosulpiride caused Parkinsonian symptoms, the dopaminergic drugs and valproate caused refractory hyponatremia followed by altered sensorium, and clidinium contributed to urinary retention.

conclusionThe case highlights the need to be vigilant for adverse consequences of the prescribing cascade, especially for antiemetic drugs, such as levosulpiride, because of its propensity to induce extrapyramidal reactions in older patients. In cases of refractory hyponatremia, a trial of de-challenge of valproate and dopaminergic drugs should be considered. The identification and removal of the culprit drugs can rescue the patient from a disabling cycle of adverse drug reactions.

Indexed as

DeprescriptionsDopamine AgentsHyponatremiaParkinsonian DisordersSulpirideValproic AcidAgedAged, 80 and overAnticonvulsantsAntiemeticsFemaleHumansAnticonvulsantsAntiemeticsDopamine AgentslevosulpirideSulpirideValproic AcidAdverse drug reactionsdrug-induced hyponatremiadrug-induced parkinsonismelderlyneuropsychiatricpharmacovigilanceprescribing cascade.

Identifiers

PMID38523545
OpenAlexW4393158009

What OpenQuestion holds

Textmetadata
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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.