Cinnarizine-induced akathisia, parkinsonism and depression: a case description
Summary. Introduction. 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 cinnarizineinduced 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 DSMIV 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
Caso clínico Se describe el caso de un paciente varón de 25 años que desarrolló un cuadro de acatisia, parkinsonismo y depresión tras 11 días de tratamiento con cinaricina por un trastorno vertiginoso. Se realizaron evaluaciones sucesivas con las siguientes escalas o instrumentos: Barnes de acatisia, Simpson-Angus para síntomas extrapiramidales, Beck de depresión, Zung de depresión y SCID para depresión mayor según el DSM-IV. El paciente recibió tratamiento con benzodiacepinas, propranolol y orfenadrina.
Conclusiones Aunque los síntomas extrapiramidales y la depresión inducidos por la cinaricina se han asociado generalmente con la edad avanzada y el tiempo prolongado de tratamiento, debe considerarse su aparición también en pacientes jóvenes y después de un corto período de tratamiento
