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Drug-Induced Cerebellar Ataxia: A Systematic Review

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Abstract

Background and Objectives

Cerebellar ataxia can be induced by a large number of drugs. We here conducted a systemic review of the drugs that can lead to cerebellar ataxia as an adverse drug reaction (ADR).

Methods

We performed a systematic literature search in Pubmed (1966 to January 2014) and EMBASE (1988 to January 2014) to identify all of the drugs that can have ataxia as an ADR and to assess the frequency of drug-induced ataxia for individual drugs. Furthermore, we collected reports of drug-induced ataxia over the past 20 years in the Netherlands by querying a national register of ADRs.

Results

Drug-induced ataxia was reported in association with 93 individual drugs (57 from the literature, 36 from the Dutch registry). The most common groups were antiepileptic drugs, benzodiazepines, and antineoplastics. For some, the number needed to harm was below 10. Ataxia was commonly reversible, but persistent symptoms were described with lithium and certain antineoplastics.

Conclusions

It is important to be aware of the possibility that ataxia might be drug-induced, and for some drugs the relative frequency of this particular ADR is high. In most patients, symptoms occur within days or weeks after the introduction of a new drug or an increase in dose. In general, ataxia tends to disappear after discontinuation of the drug, but chronic ataxia has been described for some drugs.

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Acknowledgments

No funding was received for conducting or publishing this review.

Conflict of interest

BvdW is supported by grants from the Royal Dutch Society for Physical Therapy, Radboud University Medical Centre, Gossweiler Foundation, Wetenschapsfonds Dystonievereniging, and Biobanking and Biomolecular Research Infrastructure (BBMRI-NL).

JvG is supported by the Gossweiler Foundation.

FK reports no supporting grants.

RM reports no supporting grants.

LH reports no supporting grants.

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  1. Department of Neurology 935 and Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    J. van Gaalen, F. G. Kerstens, R. P. P. W. M. Maas & B. P. C. van de Warrenburg

  2. Netherlands Pharmacovigilance Centre Lareb, ’s-Hertogenbosch, The Netherlands

    L. Härmark

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  1. J. van Gaalen
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Correspondence to B. P. C. van de Warrenburg.

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van Gaalen, J., Kerstens, F.G., Maas, R.P.P.W.M. et al. Drug-Induced Cerebellar Ataxia: A Systematic Review. CNS Drugs 28, 1139–1153 (2014). https://doi.org/10.1007/s40263-014-0200-4

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