flunarizine and Depressive-Disorder

This prospective, open multi-centre study on flunarizine focused on the risk/benefit ratio of the use of flunarizine in the prophylaxis of migraine and in the treatment of vertigo, due to disorder of the vestibular system. The assessment of risks focused on the incidence of new events of depression and/or extrapyramidal syndrome during flunarizine treatment. For migraine, flunarizine was compared to propranolol in 686 patients; for vertigo, flunarizine was compared to betahistine in 198 patients. The incidence of depression during follow-up in this study was significantly higher in the flunarizine group than in the propranolol group in the condition of migraine. There were no observations of an extrapyramidal syndrome. There was a suggestion that flunarizine has more benefits than propranolol in the condition of migraine, and that betahistine has more benefit than flunarizine in the condition of vertigo. Differences in dosages could possible explain these differences.

Topics: Adult; Data Collection; Depressive Disorder; Female; Flunarizine; Follow-Up Studies; Humans; Male; Middle Aged; Migraine Disorders; Netherlands; Product Surveillance, Postmarketing; Prospective Studies; Vasodilator Agents; Vertigo

In a clinically controlled double-blind study the effect of flunarizine (Sibelium) was compared with that of placebo in patients with involutional depression (WHO's International Classification of Diseases (ICD No. 296.0) and with cerebral circulatory disturbances (ICD No. 293.1). Effectiveness was objectified with the aid of the Clinical Global Impression test (CGI), the Hamilton Depression Scale (HAMD), the Nurses' Observation Scale for Inpatient Evaluation (NOSIE), and the "wellbeing tests" Bf-S and Bf-S'. Duration of treatment was 6 weeks. 32 patients were available for the final evaluation. In a combination of the good to excellent results considered as effective and the moderate to unsatisfactory results considered as ineffective the 82% rate of improvement in favour of the cerebral Ca2+ antagonist flunarizine was significantly superior to the 26% reached in the placebo group. The correlation with the psychopathometric tests has been proved. The medication was shown to be well tolerated. Side-effects did not appear. The mechanisms of action of the cerebral Ca2+ antagonist are discussed.

Topics: Adult; Aged; Cerebrovascular Disorders; Cinnarizine; Clinical Trials as Topic; Depressive Disorder; Double-Blind Method; Female; Flunarizine; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Random Allocation

Four patients presented symptoms of a dementia syndrome. A man aged 67 showed gradual aggravation of disorders of memory and gait, as well as subcortical infarctions. A man aged 65 had disorders of concentration non compatible with the infarctions on the MRI scan, which disappeared after discontinuation of use of flunarizine. A woman aged 55 and a man aged 52 had changes of character and infarctions in the frontal lobe. Vascular dementia is, contrary to what most criteria suggest, often a subcortical syndrome. The relationship between cerebrovascular pathology on CT and MRI scans and cognitive and behavioural disorders is often hard to establish. If the criteria for vascular dementia are applied blindly, other causes of the subcortical dementia syndrome can be missed. The present criteria offer almost no room for detecting the subtle cognitive and behavioural disorders of cerebrovascular pathology. It is important to recognize the early changes of a threatened brain, because treatment and prevention might be effective in preventing further damage.

Topics: Aged; Brain; Calcium Channel Blockers; Cerebral Infarction; Cognition Disorders; Dementia, Vascular; Depressive Disorder; Diagnosis, Differential; Fatal Outcome; Female; Flunarizine; Humans; Magnetic Resonance Imaging; Male; Mental Disorders; Middle Aged; Neurologic Examination; Neuropsychological Tests; Tomography, X-Ray Computed

Topics: Affect; Depressive Disorder; Flunarizine; Humans; Male; Middle Aged; Migraine Disorders; Problem Solving; Substance-Related Disorders

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

12 subjects, 8 women and 4 men, presented with extrapyramidal motor signs and psychic depression after treatment with flunarizine for between 3 weeks and 15 months. One woman presented with severe symptoms and 20 months after stopping flunarizine she still had dyskinesia and akathisia. The other patients showed partial or complete improvement after withdrawal of the drug.

Topics: Aged; Akathisia, Drug-Induced; Cinnarizine; Depressive Disorder; Dyskinesia, Drug-Induced; Female; Flunarizine; Humans; Male; Middle Aged; Parkinson Disease, Secondary; Psychoses, Substance-Induced