Movement disorders and depression due to flunarizine and cinnarizine

Micheli, Federico; Pardal, Manuel María Fernández; Giannaula, Rolando; Gatto, M. Lo; Parera, Ignacio Casas; Paradiso, Guillermo; Torres, Marta E; Pikielny, R; Pardal, Julio Fernández

doi:10.1002/mds.870040205

Cited by 76 publications

(26 citation statements)

References 17 publications

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“…The course of the abnormal movements paralleled that of parkinsonism and showed a long-term prognosis less favorable than that found in a shorter follow-up study (1).…”

Section: A Negrotti and S Calzettimentioning

confidence: 89%

A long‐term follow‐up study of cinnarizine‐ and flunarizine‐induced parkinsonism

Negrotti

Calzetti

1997

Movement Disorders

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The natural course of calcium-entry blocker-induced parkinsonism was evaluated in 13 elderly patients previously exposed to cinnarizine or flunarizine or both for a median period of 7 months. Clinical assessments were carried out before drug discontinuation and twice thereafter over a period lasting < or = 7 years. None of the patients showed a full recovery of extrapyramidal signs, indicating that the long-term prognosis of the parkinsonism is less benign than previously reported. Two main patterns of clinical outcome were recognized (i.e., "remittent" and "persistent and not progressive" parkinsonism), whereas the development of a progressive disorder was observed only in one patient. No significant correlation was found between the patterns of outcome and some clinical variables, such as total duration of exposure to cinnarizine and flunarizine, cumulative drug dosages, and age at onset of parkinsonism. There was no significant difference in terms of family history of essential tremor or parkinsonism or both among patients with the two main patterns of clinical course.

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“…The course of the abnormal movements paralleled that of parkinsonism and showed a long-term prognosis less favorable than that found in a shorter follow-up study (1).…”

Section: A Negrotti and S Calzettimentioning

confidence: 89%

A long‐term follow‐up study of cinnarizine‐ and flunarizine‐induced parkinsonism

Negrotti

Calzetti

1997

Movement Disorders

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“…Parkinsonism has been repeatedly documented with a variety of calcium channel antagonists, including amlodipine, cinnarizine, diltiazem, flunarizine, manidipine, and verapamil. [40][41][42][43][44][45][46][47] Although there are no direct studies of calcium channel antagonists for the treatment of human dystonia, these observations provide strong indirect evidence that calcium channel drugs should be considered as potential therapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

Calcium channel agonists and dystonia in the mouse

Jinnah

Sepkuty

et al. 2000

Mov. Disord.

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“…However, with the exception of precipitation of depression, these effects generally occur in older patients, with higher doses and in association with other drugs (cinnarazine) [17]. Therefore, high clinical surveillance of possible side effects needs to be implemented, and long-term therapy should be discouraged [18]. In fact, in our patient, we are performing 3-monthly clinical follow-up visits and will continue therapy for no longer than 2 years.…”

Section: Discussionmentioning

confidence: 99%

Episodic Spontaneous Hypothermia Potentially Triggered by Hyperinsulinemia

Capanna

Marcovecchio²,

Verrotti³

et al. 2009

Horm Res Paediatr

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Episodic spontaneous hypothermia is an infrequent disorder, the pathogenic mechanisms of which have not been completely clarified, although alterations in the serotoninergic system have been suggested. We report the history of a girl with episodes of dizziness and shivering associated with a body temperature lower than 35°C since the age of 10 months. At the age of 11 years, she was admitted to a local hospital and an oral glucose tolerance test showed high total insulin levels. Hypoglycemia secondary to hyperinsulinemia was suspected, and a low-carbohydrate (simple) diet was proposed without results. Due to the recurrence of the episodes, episodic spontaneous hypothermia triggered by hyperinsulinemia was suspected, and treatment with flunarizine, a drug considered the first line in the treatment of migraine-related disorders, was started with a resulting reduction in the episodes. A new endocrinological evaluation showed decreased insulin secretion. In our patient, the success of the therapy might be due to the well-known effect of calcium antagonists in inhibiting serotonin uptake and thereby regulating serotonin levels after hyperinsulinism. This case suggests hyperinsulinemia as a potential mechanism for episodic spontaneous hypothermia, probably mediated by an interaction between insulin and the serotoninergic system.

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Movement disorders and depression due to flunarizine and cinnarizine

Cited by 76 publications

References 17 publications

A long‐term follow‐up study of cinnarizine‐ and flunarizine‐induced parkinsonism

A long‐term follow‐up study of cinnarizine‐ and flunarizine‐induced parkinsonism

Calcium channel agonists and dystonia in the mouse

Episodic Spontaneous Hypothermia Potentially Triggered by Hyperinsulinemia

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