A case of drug induced dizziness in a patient on anti-Parkinson drugs

Abstract

Parkinson’s disease (PD) is the second most common age-related neurodegenerative disease, exceeded only by Alzheimer’s disease. Clinically, PD is characterized by resting tremor, rigidity (stiffness), bradykinesia (slowing), and gait dysfunction with postural instability. These are known as the classical or “cardinal” features of the disease. Levodopa remains the most effective symptomatic treatment for PD and the gold standard against which new therapies are compared. Levodopa is routinely administered in combination with a peripheral decarboxylase inhibitor to prevent its peripheral metabolism to dopamine and the development of nausea, vomiting, and orthostatic hypotension. The major concern with levodopa is that chronic levodopa treatment is associated with the development of motor complications, nausea and dizziness in the large majority of patients. We are here reporting a case of Syndopa plus (Levodopa+Carbidopa) induced dizziness in a 76 years old male patient on anti- parkinsonism treatment. The causality assessment was done by Naranjo scale. The causality of Syndopa plus in the case was “probable” as per Naranjo scale. The patient was managed by reducing the dose of Syndopa plus to the half of it’s initial dose. The case was recorded properly in adverse drug reaction reporting form and was sent to nearby ADR (adverse drug reaction) monitoring centre.