ArticleMovement disorders clinical practice2025
What Antiepileptics Have the Highest Risk of Parkinsonism? A Disproportionality Analysis in the World Health Organisation Pharmacovigilance Database.
Article in Movement disorders clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe present study was performed to investigate which antiepileptic drug (AED) has the highest risk of drug-induced parkinsonism (DIP).
objectiveThe aim was to evaluate associations between AEDs and DIP reports in the World Health Organization pharmacovigilance database, Vigibase.
methodsIndividual case safety reports (ICSRs) in patients ≥45 years registered between January 1, 2000 and June 31, 2024 with carbamazepine, lamotrigine, levetiracetam, or sodium valproate as "Parkinson-like events" (PLE) were extracted. Disproportionality analyses were performed, with cases being PLE and non-cases all other ICSRs. Results are shown as reporting odds ratios (ROR).
resultsAmong 16,174,796 ICSRs, 3339 reported PLE with the four AEDs, mainly in females between 45 and 64 years. The highest ROR value was with valproate sodium (3.09 [2.01-3.29]), followed by lamotrigine (2.14 [2.01-2.28]), levetiracetam (1.43 [1.32-1.55]), and carbamazepine (1.09 [1.01-1.17]). DIP risk increased with the number of associated AEDs.
conclusionsAmong AEDs, valproate sodium is associated with the higher risk of PLE and carbamazepine with the lowest.
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