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[Akathisia, parkinsonism and depression induced by cinnarizine: a case report]. 1999

S Stucchi-Portocarrero, and J M Vega-Dienstmaier, and J E Saavedra, and A Sagástegui
Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Perú. stucchi@amauta.rcp.net.pe

BACKGROUND Cinnarizine is a calcium-entry blocker drug used in vertiginous disorders; among its most rare adverse effects appear extrapyramidal symptoms and depression, these effects can persist during weeks, months or years after the withdrawal of the drug and have been explained by the inhibition of the passage of calcium in striatal neurons and a direct antidopaminergic features because of the similar chemical structure with neuroleptic drugs. Clinical case. A case of cinnarizine-induced akathisia, parkinsonism and depression in a 25 years-old patient after 11 days of treatment is described. Sequential evaluation were done using the following instruments: Barnes' scale for akathisia, Simpson-Angus scale for extrapyramidal symptoms, Beck's depression scale, Zung's depression scale and SCID for major depression according to DSM-IV criteria. The patient was treated with benzodiazepines, propranolol and orphenadrine. CONCLUSIONS Although cinnarizine-induced extrapyramidal symptoms and depression have been associated with old age and prolonged time of treatment, it must be considered its apparition among young patients and after a short time of treatment.

UI MeSH Term Description Entries
D008297 Male Males
D010302 Parkinson Disease, Secondary Conditions which feature clinical manifestations resembling primary Parkinson disease that are caused by a known or suspected condition. Examples include parkinsonism caused by vascular injury, drugs, trauma, toxin exposure, neoplasms, infections and degenerative or hereditary conditions. Clinical features may include bradykinesia, rigidity, parkinsonian gait, and masked facies. In general, tremor is less prominent in secondary parkinsonism than in the primary form. (From Joynt, Clinical Neurology, 1998, Ch38, pp39-42) Atherosclerotic Parkinsonism,Secondary Parkinsonism,Symptomatic Parkinson Disease,Parkinson Disease, Secondary Vascular,Parkinson Disease, Symptomatic,Parkinsonism, Secondary,Parkinsonism, Symptomatic,Secondary Vascular Parkinson Disease,Parkinsonism, Atherosclerotic,Secondary Parkinson Disease,Symptomatic Parkinsonism
D002121 Calcium Channel Blockers A class of drugs that act by selective inhibition of calcium influx through cellular membranes. Calcium Antagonists, Exogenous,Calcium Blockaders, Exogenous,Calcium Channel Antagonist,Calcium Channel Blocker,Calcium Channel Blocking Drug,Calcium Inhibitors, Exogenous,Channel Blockers, Calcium,Exogenous Calcium Blockader,Exogenous Calcium Inhibitor,Calcium Channel Antagonists,Calcium Channel Blocking Drugs,Exogenous Calcium Antagonists,Exogenous Calcium Blockaders,Exogenous Calcium Inhibitors,Antagonist, Calcium Channel,Antagonists, Calcium Channel,Antagonists, Exogenous Calcium,Blockader, Exogenous Calcium,Blocker, Calcium Channel,Blockers, Calcium Channel,Calcium Blockader, Exogenous,Calcium Inhibitor, Exogenous,Channel Antagonist, Calcium,Channel Blocker, Calcium,Inhibitor, Exogenous Calcium
D002936 Cinnarizine A piperazine derivative having histamine H1-receptor and calcium-channel blocking activity with vasodilating and antiemetic properties but it induces PARKINSONIAN DISORDERS. 1-(Diphenylmethyl)-4-(3-phenyl-2-propenyl)piperazine,Cinarizina Inkey,Cinarizina Ratiopharm,Cinarizine,Cinazière,Cinna,Cinnarizin AL,Cinnarizin Siegfried,Cinnarizin Von Ct,Cinnarizin-Ratiopharm,Cinnarizine L-Tartrate,Cinnarizine L-Tartrate (1:1),Cinnarizine, (E)-Isomer,Cinnarizine, Dihydrochloride,Cinnipirine,Cisaken,Dimitronal,R-516,Stugeron,Stugeron Forte,Cinnarizin Ratiopharm,Cinnarizine L Tartrate,Dihydrochloride Cinnarizine,L-Tartrate, Cinnarizine,R 516,R516,Von Ct, Cinnarizin
D003866 Depressive Disorder An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. Depression, Endogenous,Depression, Neurotic,Depression, Unipolar,Depressive Syndrome,Melancholia,Neurosis, Depressive,Unipolar Depression,Depressions, Endogenous,Depressions, Neurotic,Depressions, Unipolar,Depressive Disorders,Depressive Neuroses,Depressive Neurosis,Depressive Syndromes,Disorder, Depressive,Disorders, Depressive,Endogenous Depression,Endogenous Depressions,Melancholias,Neuroses, Depressive,Neurotic Depression,Neurotic Depressions,Syndrome, Depressive,Syndromes, Depressive,Unipolar Depressions
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001480 Basal Ganglia Diseases Diseases of the BASAL GANGLIA including the PUTAMEN; GLOBUS PALLIDUS; claustrum; AMYGDALA; and CAUDATE NUCLEUS. DYSKINESIAS (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include CEREBROVASCULAR DISORDERS; NEURODEGENERATIVE DISEASES; and CRANIOCEREBRAL TRAUMA. Extrapyramidal Disorders,Basal Ganglia Disorders,Lenticulostriate Disorders,Basal Ganglia Disease,Basal Ganglia Disorder,Extrapyramidal Disorder,Lenticulostriate Disorder
D012720 Severity of Illness Index Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder. Illness Index Severities,Illness Index Severity
D014717 Vertigo An illusion of movement, either of the external world revolving around the individual or of the individual revolving in space. Vertigo may be associated with disorders of the inner ear (EAR, INNER); VESTIBULAR NERVE; BRAINSTEM; or CEREBRAL CORTEX. Lesions in the TEMPORAL LOBE and PARIETAL LOBE may be associated with FOCAL SEIZURES that may feature vertigo as an ictal manifestation. (From Adams et al., Principles of Neurology, 6th ed, pp300-1) CNS Origin Vertigo,Central Nervous System Origin Vertigo,Positional Vertigo,Spinning Sensation,Vertigo, Brain Stem,Vertigo, Brainstem,Vertigo, Central Nervous System Origin,Vertigo, Central Origin,Vertigo, Constant,Vertigo, Essential,Vertigo, Intermittant,Vertigo, Paroxysmal,Vertigo, Peripheral,Vertigo, Subjective,Brain Stem Vertigo,Brain Stem Vertigos,Brainstem Vertigo,Brainstem Vertigos,CNS Origin Vertigos,Central Origin Vertigo,Central Origin Vertigos,Constant Vertigo,Constant Vertigos,Essential Vertigo,Essential Vertigos,Intermittant Vertigo,Intermittant Vertigos,Origin Vertigo, CNS,Origin Vertigo, Central,Origin Vertigos, CNS,Origin Vertigos, Central,Paroxysmal Vertigo,Paroxysmal Vertigos,Peripheral Vertigo,Peripheral Vertigos,Sensation, Spinning,Sensations, Spinning,Spinning Sensations,Subjective Vertigo,Subjective Vertigos,Vertigo, CNS Origin,Vertigo, Positional,Vertigos,Vertigos, Brain Stem,Vertigos, Brainstem,Vertigos, CNS Origin,Vertigos, Central Origin,Vertigos, Constant,Vertigos, Essential,Vertigos, Intermittant,Vertigos, Paroxysmal,Vertigos, Peripheral,Vertigos, Subjective

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