Editing Parkinsonism (section)

==Differential diagnosis ==
Secondary parkinsonism, including vascular parkinsonism and drug-induced parkinsonism.<ref>{{cite journal |vauthors=Del Toro-Pérez C, Guevara-Sánchez E, Martínez-Sánchez P |title=Treatment of Vascular Parkinsonism: A Systematic Review |journal=Brain Sci |volume=13 |issue=3 |date=March 2023 |page=489 |pmid=36979299 |pmc=10046744 |doi=10.3390/brainsci13030489 |url= |doi-access=free }}</ref><ref>{{cite journal |vauthors=Shin HW, Hong SW, Youn YC |title=Clinical Aspects of the Differential Diagnosis of Parkinson's Disease and Parkinsonism |journal=J Clin Neurol |volume=18 |issue=3 |pages=259–270 |date=May 2022 |pmid=35589315 |pmc=9163948 |doi=10.3988/jcn.2022.18.3.259 |url=}}</ref>

=== Drug-induced parkinsonism ===
About 7% of people with parkinsonism developed symptoms as a result of side effects of medication, mainly neuroleptic [[antipsychotic]]s especially the [[phenothiazine]]s (such as [[perphenazine]] and [[chlorpromazine]]), [[thioxanthene]]s (such as [[flupentixol]] and [[zuclopenthixol]]) and [[butyrophenone]]s (such as [[haloperidol]]), and rarely, [[antidepressant]]s. Yet another drug that can induce parkinsonism is the [[antihistaminic]] medication [[cinnarizine]], usually prescribed for motion sickness; this is because besides antagonizing [[histamine receptors]] this drug antagonizes the [[dopamine D2 receptor]]s.<ref name="Marti-Masso" /> The incidence of drug-induced parkinsonism increases with age. Drug-induced parkinsonism tends to remain at its presenting level and does not worsen like Parkinson's disease.<ref>{{cite web | url = http://www.parkinsons.org.uk/PDF/FS38_druginducedparkinsonism.pdf | title = Information Sheet: Drug-induced Parkinsonism | publisher = Parkinson's Disease and Society |access-date = 2013-04-15 | url-status = dead | archive-url = https://web.archive.org/web/20130626024034/http://www.parkinsons.org.uk/PDF/FS38_druginducedparkinsonism.pdf | archive-date = 2013-06-26 }}</ref>

Implicated medications include:
* [[Antipsychotics]]<ref name="Bradley2004" />
* [[Lithium (medication)|Lithium]]<ref name="Bradley2004" />
* [[Metoclopramide]]<ref>{{cite journal | vauthors = Shuaib UA, Rajput AH, Robinson CA, Rajput A | title = Neuroleptic-induced Parkinsonism: Clinicopathological study | journal = Movement Disorders | volume = 31 | issue = 3 | pages = 360–5 | date = March 2016 | pmid = 26660063 | pmc = 5064745 | doi = 10.1002/mds.26467 }}</ref>
* [[MDMA]] (addiction and frequent use)<ref>{{cite journal | vauthors = Louis ED, Ottman R | title = Is there a one-way street from essential tremor to Parkinson's disease? Possible biological ramifications | journal = European Journal of Neurology | volume = 20 | issue = 11 | pages = 1440–4 | date = November 2013 | pmid = 24033795 | pmc = 3801177 | doi = 10.1111/ene.12256 | type = Review }}</ref><ref>{{cite journal |author=Fabrizi, Monaco, Dalla Libera |title=Parkinsonian syndrome following MDMA (Ecstasy) addiction |journal=Movement Disorders |volume=19 |pages=S73–S74 |year=2004}}</ref>
* [[Tetrabenazine]]<ref name="Bradley2004" />
* [[Cinnarizine]]<ref name="Marti-Masso">{{cite journal |first1=José F. |first2=Juan J. |url=https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.870130313 |journal=Movement Disorders |publisher=International Parkinson and Movement Disorder Society/Wiley |issn=1531-8257 |editor1-first=A. Jon |editor1-last=Stoessl |editor2-first=Christine |editor2-last=Klein |editor3-first=David G. |editor3-last=Standaert |publication-place=[[Vancouver]], [[British Columbia]], [[Canada]] |title=Cinnarizine-induced parkinsonism: ten years later |last1=Martí-Massó |last2=Poza |doi=10.1002/mds.870130313 |pmid=9613736 |date=1 May 1998 |volume=13 |issue=3 |pages=453–456
|s2cid=31516105 }}</ref>