The Cardiovascular Safety of Antiparkinsonian Drugs—Analysis of Signals in the FDA Adverse Event Report System Database

OBJECTIVE: This study aimed to investigate the characteristics and spectrum of cardiotoxicity induced by various antiparkinsonian drugs based on the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database. METHODS: Data from the FAERS database from the first quarter of 2004 to the third quarter of 2025 were downloaded for disproportionality analysis. We employed validated disproportionality metrics including the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN) and multi-item gamma Poisson shrinker (MGPS) to detect significant drug-event associations. RESULTS: After removing duplicates, a total of 42 583 cases of patients treated with antiparkinsonian drugs were included in the FAERS database. Dopamine receptor agonists exhibited the most extensive range of cardiac adverse events. Monoamine oxidase B inhibitors displayed the second broadest range of toxicity. As for catechol-O-methyltransferase inhibitors, a total of six signals were detected in entacapone. Four signals were detected for amantadine, while no signals were identified for levodopa. CONCLUSION: This study highlights the cardiovascular adverse reactions associated with Parkinson's treatment drugs. These findings underscore the importance of monitoring and evaluating the cardiovascular safety of antiparkinsonian medications.