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Prevalence and causative drugs of drug-induced Parkinsonism in pediatric patients

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Abstract

Although several studies provided evidence on the epidemiology of drug-induced Parkinsonism (DIP) and its causative drugs, it is still limited in pediatrics. This study aimed to investigate the prevalence and risk of DIP in pediatrics. We used the Health Insurance Review and Assessment Service–Pediatric Patients Sample in Korea between 2010 and 2017 to estimate the annual prevalence of DIP and causative drug use using a cross-sectional design. The risk of DIP associated with causative drugs was evaluated using a case-crossover design. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated using a conditional logistic regression. A total of 2925 pediatric patients had diagnosed with DIP from 2010 to 2017. Most patients were aged between 12 and19 years old, and 99.8% had any diagnosis of mental health disorder (MHD). During the study period, the prevalence of DIP increased by 10.0-fold from 2010 to 2017. All causative drugs showed a corresponding increase in their use, with atypical antipsychotics being the most prominent (increase ratio, 2.07). For both in the prevalence of DIP and atypical antipsychotic use, the increment was much bigger in patients with non-psychotic MHD than that in patients with psychotic MHD. In the case-crossover study, antipsychotics showed the largest aOR with DIP. Risperidone among antipsychotics showed the highest risk for DIP (aOR = 7.09, 95% CI = 3.83–13.09), followed by aripiprazole (aOR = 5.03, 95% CI = 2.88–8.80). This study suggests that the increase in DIP prevalence in pediatric patients might be because of the increased use of atypical antipsychotics.

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Data availability

The data that support the findings of this study are available from the Health Insurance Review and Assessment (HIRA) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of HIRA (https://opendata.hira.or.kr/).

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Acknowledgements

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF- 2022R1I1A1A01065589). This study used the HIRA data.

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2022R1I1A1A01065589).

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Author notes

  1. Soo Min Jeon and Yu Jin Lee contributed equally as co-first authors.

Authors and Affiliations

  1. College of Pharmacy, Jeju National University, Jeju, South Korea

    Soo Min Jeon

  2. BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-Ro, Daegu, 41566, South Korea

    Yu Jin Lee & Jin-Won Kwon

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  1. Soo Min Jeon
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Contributions

SMJ and YJL had full access to all study data and took responsibility for the integrity of the data and the accuracy of the data analysis. All authors were responsible for the study concept and design and involved in the acquisition and interpretation of data. SMJ and YJL drafted the original manuscript. All authors critically revised the manuscript and provided their final approval for the version to be published and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jin-Won Kwon.

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Conflict of interest

The authors have no conflicts of interest relevant to this article to disclose.

Ethical approval

This study was approved by the Institutional Review Board of Kyungpook University in September 2018 (IRB number KNU2018-0141). The requirement for the acquisition of informed consent from the study population was waived by the board because the data was anonymous and cannot be personally identified.

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Jeon, S.M., Lee, Y.J. & Kwon, JW. Prevalence and causative drugs of drug-induced Parkinsonism in pediatric patients. Eur Child Adolesc Psychiatry 32, 1805–1814 (2023). https://doi.org/10.1007/s00787-023-02207-7

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