cinnarizine and Parkinson-Disease

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

The effect of cinnarizine on motor function in Parkinson's disease was evaluated in a randomised double-blind parallel study of 20 patients. Both groups were comparable in age, duration of the disease, dose of levodopa and degree of disability. A significant worsening of mobility was observed in patients treated with cinnarizine (75 mg bd), whilst no change was recorded in patients receiving placebo. Cinnarizine should be added to the list of drugs capable of aggravating Parkinson's disease.

Topics: Aged; Aged, 80 and over; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Motor Skills; Parkinson Disease; Random Allocation

We performed a clinical report based, descriptive and retrospective study, aimed at comparing Flunarizine/Cinnarizine-induced parkinsonism (FCIP) patients and Parkinson's disease (PD) patients. The FCIP group (n = 30) presented a lower frequency of rigidity and unilateral tremor than the PD group (n = 70). All FCIP patients improved, 13 after dopaminergic treatment. FCIP patients who improved spontaneously presented lower frequency of rigidity, compared with the other FCIP subgroup and PD group. FCIP patients who did not improve spontaneously showed a clinical pattern similar to PD patients.

Topics: Aged; Aged, 80 and over; Calcium Channel Blockers; Cinnarizine; Dopamine Agonists; Female; Flunarizine; Humans; Male; Middle Aged; Muscle Rigidity; Parkinson Disease; Parkinsonian Disorders; Retrospective Studies; Statistics, Nonparametric; Treatment Outcome; Tremor

Drug-induced Parkinsonism (DIP) is the second commonest cause of Parkinson syndrome, after Parkinson disease (PD) and represents between 10% and 30% of all patients with Parkinsonism.. To study the frequency and drugs responsible for DIP and to compare some of the clinical characteristics of these patients and those with PD.. A retrospective community based study in Bajo Aragon district to determine the frequency of PD and other Parkinsonism, including DIP. PD was diagnosed on the criteria proposed by the United Kingdom Parkinson's Disease Society Brain Bank and DIP on the criteria of Jiménez et al.. Calcium antagonists were the cause of 73% of the DIP, followed by neuroleptic drugs (11.5%). There were 73% women (19/26). The patients with DIP were older than those with PD when their symptoms started (p = 0.02). In patients with DIP, 48% presented with bilateral symptoms as compared with 7% in PD (p < 0.0001).. 1. Cinarizine is the main drug responsible for DIP (58%) 2. As compared with patients with PD, patients with DIP are mainly women, older, more frequently have bilateral onset of symptoms and consult the doctor sooner.

Topics: Aged; Calcium Channel Blockers; Cinnarizine; Female; Humans; Male; Middle Aged; Parkinson Disease; Parkinson Disease, Secondary; Retrospective Studies

The aim of the present study is to investigate whether there are geographic differences in the etiology of parkinsonism (PA).. 72% of patients with PA evaluated at movement disorders clinics in the Northern Hemisphere are diagnosed with Parkinson's disease (PD). Data regarding other regions are not available.. We reviewed the charts of all patients with PA seen at the Federal University of Minas Gerais Movement Disorders Clinic from July 1993 through October 1995. PA was diagnosed by the presence of at least two of the following: rest tremor, bradykinesia, rigidity, and postural instability. The different etiologies were diagnosed based on standard clinical criteria.. During the period of the study, PA was recognized in 338 subjects. The following clinical diagnoses were made: PD (68.9%), drug-induced PA (DIP) (13.3%), vascular PA (4.7%), Progressive supranuclear palsy (PSP) (2%), multiple system atrophy (MSA) (1.8%), others (9.7%). Cinnarizine, haloperidol and flunarizine were the commonest drugs related to DIP.. Similarly to other studies, PD accounts for about 70% of PA patients. However, there are differences between our results and previous series. DIP is much more common in the present series. This may be accounted for a more liberal use of antidopaminergic drugs in our environment, especially Calcium channel blockers. The lower frequency of MSA and PSP in our study may reflect a short follow-up, since many patients initially diagnosed with PD later are found to have Parkinson-plus syndromes.

Topics: Aged; Anti-Dyskinesia Agents; Brazil; Calcium Channel Blockers; Cinnarizine; Female; Flunarizine; Haloperidol; Histamine H1 Antagonists; Humans; Male; Middle Aged; Parkinson Disease; Parkinson Disease, Secondary

Twenty-six patients under treatment with the calcium channel blockers flunarizine (Fz) or cinnarizine (Cz) were examined-with single-photon emission computed tomography using [123I]iodobenzamide as a ligand. The striatal dopamine D2 receptor-binding potential was determined and found to be reduced by 14 to 63% (39.5 +/- 15.0%; p < 0.0001) in patients compared with age-matched control values. This reduction was larger in 12 patients with extrapyramidal symptoms and was only slowly reversible after discontinuation of treatment. Patients treated for > 6 months had significantly larger reductions than patients treated for a shorter period. Parkinsonian symptoms were only seen in patients older than 50 years. Our findings prove a neuroleptic-like action of Fz and Cz, which seems to be the major reason for their extrapyramidal side effects. Older age and long-term treatment are predisposing factors for these effects.

Topics: Adult; Aged; Brain Diseases; Cinnarizine; Dopamine D2 Receptor Antagonists; Female; Flunarizine; Humans; Male; Middle Aged; Parkinson Disease; Tomography, Emission-Computed, Single-Photon