Amiodarone and Parkinsonism: a pharmacovigilance study

Abstract

Background Some case reports have described parkinsonism with amiodarone. We investigated a putative association between parkinsonism and exposure to amiodarone. Methods We used the WHO pharmacovigilance database (VigiBase®). All adverse drug reactions with ‘Parkinson‐like events’ and amiodarone were included. Four disproportionality analyses were performed: 1/after inclusion of all reports, 2/according to sex, 3/for the twenty last years (2000–2019), and 4/after exclusion of concomitant drugs known to induce parkinsonism (antipsychotic, antivertigo, antiemetic antinauseant drugs, flunarizine). Results are expressed as reporting odds ratios (ROR; 95% CI) and information component (IC). Results No significant association was found in the whole population [ROR = 0.83 (0.65–1.06), IC = −0.7 (IC025 = −0.65)], in men, in women, for the 2000–2019 years, or after exclusion of drugs inducing parkinsonism. Conclusion We failed to find any signal of parkinsonism with amiodarone. We suggest that reports of parkinsonism with amiodarone could be mainly explained by other underlying causes.

Protective Role of Amiodarone on Reperfusion Arrhythmia in Patients of Acute Myocardial Infarction with Percutaneous Coronary Intervention Treatment

“…In IRI, amiodarone not only acts as an antiarrhythmic but also protects cardiomyocytes [ 15 ]. After the occurrence of AMI, the permeability of the myocardial cell membrane increases, causing the intracellular CK-MB and cTnI to leak out, resulting in an increase in the concentration of CK-MB and cTnI in the blood of patients, so the levels of the two are more sensitive indicators to reflect the degree of myocardial injury [ 16 ].…”

Parkinsonism and tremor syndromes

“…Calcium channel blockers such as cinnarizine, which act both on pre and post-synaptic dopamine receptors, have been readily associated with both postural tremor and parkinsonism [155]. Amiodarone has been associated with postural and intention tremor [158] and parkinsonism [159], although a recent review of a pharmacovigilance database could not find a significant association between parkinsonism and amiodarone use [160]. Antidepressants are well-known causes of ETlike tremor and parkinsonism, as reported in national adverse event reporting systems [161,162].…”