Article type: Review Article
Article
title: Cinnarizine-
and flunarizine-associated movement disorder: a literature review
Journal: The
Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Year: 2020
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari
Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Introduction: Cinnarizine (CNZ) and flunarizine (FNZ)
belong to the calcium channel blockers class of medication. Main text: The aim
of this literature review is to evaluate the clinical epidemiological profile,
pathological mechanisms, and management of CNZ/FNZ-associated movement disorder
(MD). Relevant reports in six databases were identified and assessed by two
reviewers without language restriction. One hundred and seventeen reports
containing 1920 individuals who developed a CNZ/FNZ-associated MD were
identified. The MD encountered were 1251 parkinsonism, 23 dyskinesias, 11
akathisia, 16 dystonia, and 5 myoclonus, and in the group not clearly defined,
592 extrapyramidal symptoms, 19 tremors, 2 bradykinesia, and 1 myokymia. The
predominant sex was female with a percentage of 72.69% (466/641). The mean age
was 74.49 (SD, 7.88) years. The mean CNZ dose was 148.19 mg (SD, 42.51) and for
the FNZ dose, 11.22 mg (5.39). The mean MD onset and recovery were 1.83 years
(SD, 1.35) and 3.71 months (SD, 1.26). In the subgroup of subjects that had
improvement of the symptoms, the complete recovery was achieved within 6 months
of the drug withdrawal in almost all subjects (99%). The most common management
was drug withdrawal. A complete recovery was observed in 93.77% of the patients
(437/466). Conclusions: CNZ/FNZ-associated MD was extensively reported in the
literature. Parkinsonism was the most well described. Myoclonus (MCL) was the
poorest described MD with missing data about the neurological examination and
electrodiagnostic studies. The knowledge of this disorder probably can
contribute to the understanding of the other drug-induced MDs.
Keywords: Cinnarizine, flunarizine, review, movement disorder, drug-induced
Full text available at:
https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00197-w
DOI
10.1186/s41983-020-00197-w
Citation
Rissardo JP, Caprara AL. Cinnarizine-and
flunarizine-associated movement disorder: a literature review. Egypt J Neurol
Psychiatry Neurosurg 2020;56:1-23.
