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Volume 4 Toxicology: Open Access
ISSN: 2476-2067 Toxicology Congress 2018
March 12-14, 2018
March 12-14, 2018 Singapore
14th World Congress on
Toxicology and Pharmacology
Case study: A unique case of Flunarizine induced extrapyramidal syndrome and depression
Abirami Raghunath, V Krishnan and Raman Krishnan
Saveetha Medical College and Hospital, India
Flunarizine is one of the cerebro-selective calcium channel blockers, commonly prescribed for migraine prophylaxis in
neurology clinics. It is considered as non-inferior to Propranolol and Amitriptyline when used to reduce the frequency
of migraine attacks. Here we report a case of Flunarizine induced extrapyramidal syndrome and depression. A 37 year old
female on tablet Flunarizine 15 mg daily for the past month to treat migraine, shows signs of depression and restlessness,
propensity to bend, slow reactions and mask face. Depression was rated using patient health questionnaire and extrapyramidal
syndrome was diagnosed by modified Simpson Angus scale and Barnes Akathisia Rating scale. Considering nil organic lesion
and improvement of all symptoms with the cessation of Flunarizine, the case was diagnosed as Flunarizine induced depression
and extrapyramidal disorder. Our case is unique in the way that our patient developed depression apart frommixed symptoms
of extrapyramidal disorder. Exact mechanism of Flunarizine induced depression is not understood. Commonly, the onset of
these symptoms varies from 3 months to 20 months after initiating treatment with Flunarizine, whereas in this case, symptoms
were seen within the first month of treatment. Depression was evident even when the patient was on other antidepressants
prescribed by a psychiatrist, namely Escitalopram and Buspirone. Symptoms improved only after cessation of Flunarizine from
the prescription.
Biography
Abirami Raghunath is currently pursuing her MBBS from Saveetha Medical College and Hospital, SIMATS. Her area of research is pharmacovigilance under the
mentorship of Dr. V. Krishnan, Department of Pharmacology, SIMATS in India.
Abirami Raghunath et al., Toxicol Open Access 2018, Volume 4
DOI: 10.4172/2476-2067-C1-005