title: Chronic Parkinsonism secondary to intravenous injection of meperidine analogues.
abstract: Abuse of 4-propyloxy-4-phenyl-N-methylpiperidine, a meperidine congener, produced parkinsonism in a 23-year-old man. Unlike other drug-induced motor disturbances, the syndrome persisted for 18 months and responded to drugs that stimulate dopamine receptors. Biogenic amines and metabolites in the cerebrospinal fluid and microscopic evaluation of the brain at necropsy were consistent with damage to aminergic neurons in the substantia nigra.
mesh_terms: D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use; D002230:Carbidopa / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008125:Locus Coeruleus / Q000187:drug effects; D008297:Male; D008614:Meperidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D009293:Opioid-Related Disorders / Q000150:complications; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000188:drug therapy; D013378:Substantia Nigra / Q000187:drug effects
chemical_list: C026733:4-propionyloxy-4-phenyl-N-methylpiperidine; D001971:Bromocriptine; D007980:Levodopa; D008614:Meperidine; D002230:Carbidopa