L-type calcium channel blockers and a symptom complex mimicking de Melo-Souza’s syndrome
Drugs are an important cause of tremor in the elderly and the second most common cause of Parkinsonism. Common medications which induce tremor include salbutamol, theophylline, valproate, anti-depressants, anti-psychotics, and anti-dopaminergics [1, 2]. The T-type calcium channel blockers (CCBs), cinnarizine and flunarizine, are classically associated with a syndrome known as the “de Melo-Souza’s syndrome,” or flunarizine-cinnarizine-induced Parkinsonism (FCIP) [3, 4]. FCIP is diagnosed in a patient on these drugs, with any two of tremor, hypokinesia, rigidity, and postural instability. In its classic form, it mimics idiopathic Parkinson’s disease. The syndrome is often associated with depression and other features may include anxiety, insomnia, decreased facial expression, decreased deep tendon reflexes, and generalized weakness. Older females are the usual victims and the symptoms resolve following discontinuation of the concerned CCB [3, 4]. We present the case of an...
Elderly Pharmacovigilance Programme has funding support from the National Programme for Healthcare of the Elderly, Ministry of Health and Family Welfare, Government of India.
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Conflict of interest
The authors declare that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Elderly Pharmacovigilance Programme has the institutional ethics committee approval no. Dean/2015-16/IEC/411.
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