Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications

SUMMARY OBJECTIVES: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain. METHODS: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic Antagonists; Dopamine Agents). All of them were examined at two different moments, with and without medication, and analyzed for painful symptoms. The Hoehn and Yahr scale was used for functional staging of the disease. Pain intensity was assessed by using the numerical verbal scale. RESULTS: The mean pain intensity among those on medication {2.17±0.39 (SE)} was significantly lower than in the abstinence group {4.2±0.59 (SE), p=0.006, Wilcoxon}, which corresponded to the increase in the total functional staging score from 93 to 111, respectively. CONCLUSION: The interruption of the administration of specific medications in patients with Parkinson’s disease caused, or increased the intensity of, painful discomfort correlated with the intensity of functional impairment. This effect was also observed in women, but it was statistically relevant only for men. The results suggest that pain may be a “red flag” that points to the need for a therapeutic drug review when its presence or worsening is detected.

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Main Authors: Lopes,Rosimary Amorim, Oliveira Júnior,José Oswaldo de, Porto,Fabio Henrique de Gobbi, Botelho,Ricardo Vieira
Format: Digital revista
Language:English
Published: Associação Médica Brasileira 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000100125
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spelling oai:scielo:S0104-423020210001001252021-06-16Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medicationsLopes,Rosimary AmorimOliveira Júnior,José Oswaldo dePorto,Fabio Henrique de GobbiBotelho,Ricardo Vieira Pain Parkinson’s disease Levodopa Cholinergic Antagonists Dopamine Agents Drug Therapy SUMMARY OBJECTIVES: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain. METHODS: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic Antagonists; Dopamine Agents). All of them were examined at two different moments, with and without medication, and analyzed for painful symptoms. The Hoehn and Yahr scale was used for functional staging of the disease. Pain intensity was assessed by using the numerical verbal scale. RESULTS: The mean pain intensity among those on medication {2.17±0.39 (SE)} was significantly lower than in the abstinence group {4.2±0.59 (SE), p=0.006, Wilcoxon}, which corresponded to the increase in the total functional staging score from 93 to 111, respectively. CONCLUSION: The interruption of the administration of specific medications in patients with Parkinson’s disease caused, or increased the intensity of, painful discomfort correlated with the intensity of functional impairment. This effect was also observed in women, but it was statistically relevant only for men. The results suggest that pain may be a “red flag” that points to the need for a therapeutic drug review when its presence or worsening is detected.info:eu-repo/semantics/openAccessAssociação Médica BrasileiraRevista da Associação Médica Brasileira v.67 n.1 20212021-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000100125en10.1590/1806-9282.67.01.20200709
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language English
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author Lopes,Rosimary Amorim
Oliveira Júnior,José Oswaldo de
Porto,Fabio Henrique de Gobbi
Botelho,Ricardo Vieira
spellingShingle Lopes,Rosimary Amorim
Oliveira Júnior,José Oswaldo de
Porto,Fabio Henrique de Gobbi
Botelho,Ricardo Vieira
Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
author_facet Lopes,Rosimary Amorim
Oliveira Júnior,José Oswaldo de
Porto,Fabio Henrique de Gobbi
Botelho,Ricardo Vieira
author_sort Lopes,Rosimary Amorim
title Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
title_short Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
title_full Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
title_fullStr Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
title_full_unstemmed Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
title_sort effect of medication withdrawal on pain in parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications
description SUMMARY OBJECTIVES: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain. METHODS: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic Antagonists; Dopamine Agents). All of them were examined at two different moments, with and without medication, and analyzed for painful symptoms. The Hoehn and Yahr scale was used for functional staging of the disease. Pain intensity was assessed by using the numerical verbal scale. RESULTS: The mean pain intensity among those on medication {2.17±0.39 (SE)} was significantly lower than in the abstinence group {4.2±0.59 (SE), p=0.006, Wilcoxon}, which corresponded to the increase in the total functional staging score from 93 to 111, respectively. CONCLUSION: The interruption of the administration of specific medications in patients with Parkinson’s disease caused, or increased the intensity of, painful discomfort correlated with the intensity of functional impairment. This effect was also observed in women, but it was statistically relevant only for men. The results suggest that pain may be a “red flag” that points to the need for a therapeutic drug review when its presence or worsening is detected.
publisher Associação Médica Brasileira
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000100125
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