cinnarizine and Basal-Ganglia-Diseases

Flunarizine and cinnarizine have been well documented to cause EPS. Other CCBs, on rare occasions, also have been reported to cause EPS. Theoretical explanations for these events include the inhibition of calcium influx into striatal cells and direct dopaminergic antagonistic properties. In addition, the chemical structures of flunarizine and cinnarizine, which are related to neuroleptics, may explain the relatively greater incidence of EPS with these agents. Suggested risk factors for acquiring EPS with flunarizine or cinnarizine use appear to be age, although experience with using these agents in younger patients is limited, and a family history of tremors and/or Parkinson's disease. The onset and type of presentation is unpredictable and, in most instances, discontinuation of the medication relieves the symptoms within a few days to months. Pharmacologic management of EPS with continued use of the offending agent generally has not been of clinical benefit. In conclusion, patients receiving CCBs, particularly flunarizine and cinnarizine, should be monitored for EPS.

Topics: Basal Ganglia Diseases; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Flunarizine; Humans; Parkinson Disease; Risk Factors

Topics: Basal Ganglia Diseases; Cinnarizine; Female; Humans; Middle Aged; Motion Sickness

Topics: Aged; Basal Ganglia Diseases; Cinnarizine; Depressive Disorder; Female; Flunarizine; Follow-Up Studies; Humans; Male; Middle Aged

Over the last few years, cases of movement disorders induced by flunarizine and cinnarizine have been increasingly reported. We describe a series of 101 patients, whose ages ranged from 37 to 84 years (mean 69.1), developing abnormal movements frequently associated with depression, secondary to treatment with either or both drugs. Symptoms closely resembled those induced by neuroleptic drugs and remitted on drug discontinuance in all but five cases after 5-22 months' follow-up. Whether or not such undesirable side effects are attributable to calcium antagonism and/or dopamine receptor blockade, long-term treatment with flunarizine or cinnarizine should be discouraged, particularly in the elderly.

Topics: Adult; Aged; Aged, 80 and over; Basal Ganglia Diseases; Cinnarizine; Depression; Dyskinesia, Drug-Induced; Dystonia; Female; Flunarizine; Humans; Male; Middle Aged; Parkinson Disease, Secondary; Tremor

Topics: Basal Ganglia Diseases; Cinnarizine; Clinical Trials as Topic; Flunarizine; Humans; Patient Education as Topic; Placebos; Random Allocation

Topics: Aged; Anticonvulsants; Basal Ganglia Diseases; Cinnarizine; Flunarizine; Humans; Middle Aged

Topics: Adult; Aged; Akathisia, Drug-Induced; Basal Ganglia Diseases; Cinnarizine; Depression; Female; Flunarizine; Humans; Male; Middle Aged; Vasodilator Agents

Topics: Adult; Aged; Aged, 80 and over; Basal Ganglia Diseases; Cerebrovascular Disorders; Cinnarizine; Female; Flunarizine; Humans; Male; Middle Aged; Placebos