Lower Extremity Tremor Exacerbation due to Rivastigmine Administration for Treatment of Parkinson’s Disease Dementia

  • Şeyma Kılıç
  • Nesrin Helvaci Yilmaz
  • Lütfü Hanoğlu
  • Fahriye Feriha Özer
Keywords: Rivastigmine, tremor

Abstract

Rivastigmine is one of the approved effective treatments for Parkinson's Disease Dementia (PDD). Increase of upper extremity resting tremor is a common adverse effect seen in patients administered rivastigmine and is usually mild, not leading to treatment withdrawal. Rivastigmine patch was given to both of our patients diagnosed with PDD and they suffered from postural instability and lower extremity tremor that occurred while standing and disappeared with walking after the administration and increase dosage of the drug in a few months time. The lower extremity tremor disappeared markedly in both patients after the dose reduction. Disabling lower extremity tremor due to rivastigmine dosage increase has not been reported before. We want to draw attention to this rare side effect through these patients and mention not to quit the drug.

References

Buter TC, van den Hout A, Matthews FE, Larsen JP, Brayne C, Aarsland D. Dementia and survival in Parkinson disease: a 12-year population study. Neurology 2008;70:1017-22.

Aarsland D, Anderson K, Larsen JP, Lolk A, Nielsen H, Kragh-Sørensen P. Risk of dementia in Parkinson’s disease–a community-based, prospective study. Neurology 2001;56:730-6.

Leroi I, Brandt J, Reich SG Lyketsos CG, Grill S, Thompson R, et al. Randomized placebocontrolled trial of donepezil in cognitive impairment in Parkinson’s disease. Int J Geriatr Psychiatry 2004;19:1-8.

Kövari E, Gold G, Herrmann FR, Canuto A, Hof PR, Bouras C, et al. Lewy body densities in the entorhinal and anterior cingulate cortex predict cognitive deficits in Parkinson's disease. Acta Neuropathol 2003;106:83.

Aarsland D, Laake K, Larsen JP, Janvin C. Donepezil for cognitive impairment in Parkinson’s disease: a randomized controlled trial. J Neurol Neurosurg Psychiatry 2002;72:708-12.

Aarsland D, Cummings J, Larsen J. Neuropsychiatric differences between Parkinson’s disease with dementia and Alzheimer’s disease. Int J Geriatr Psychiatry 2001;16:184-191.

Emre M, Aarsland D, Albanese A, Byrne EJ, Deuschl G, De Deyn PP, et al. Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med 2004;351:2509-18.

Wesnes KA, McKeith I, Edgar C, Emre M, Lane R. Benefits of rivastigmine on attention in dementia associated with Parkinson disease. Neurology 2005;65:1654-6.

Burn D, Emre M, McKeith I, De Deyn PP, Aarsland D, Hsu C, et al. Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson’s disease. Mov Disord 2006;21:1899-1907.

Svenningsson P, Westman E, Ballard C, Aarsland D. Cognitive impairment in patients with Parkinson's disease: diagnosis, biomarkers, and treatment. Lancet Neurol 2012;11:697-707.

Tiraboschi P, Hansen LA, Alford M, Sabbagh MN, Schoos B, Masliah E, et al. Cholinergic dysfunction in diseases with Lewy bodies. Neurology 2000;54:407-11.

Lefèvre G, Sedek G, Huang HL, Saltzman M, Rosenberg M, Kiese B, et al. Pharmacokinetics of a rivastigmine transdermal patch formulation in healthy volunteers: relative effects of body site application. J Clin Pharmacol 2007;47:471-8.

Oertel W, Poewe W, Wolters E, De Deyn PP, Emre M, Kirsch C, et al. Effects of rivastigmine on tremor and other motor symptoms in patients with Parkinson's disease dementia: a retrospective analysis of a double-blind trial and an open-label extension. Drug Saf 2008;31:79-94.

Richard IH, Justus AW, Greig NH, Marshall F, Kurlan R. Worsening of motor function and mood in a patient with Parkinson’s disease after pharmacologic challenge with oral rivastigmine. Clin Neuropharmacol 2002;25:296-9.

Gurevich TY, Shabtai H, Korczyn AD, Simon ES, Giladi N. Effect of rivastigmine on tremor in patients with Parkinson's disease and dementia. Mov Disord 2006;21:1663-6.

Published
2018-03-15