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[桂利嗪诱发的静坐不能、帕金森综合征和抑郁:1例报告]

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

作者信息

Stucchi-Portocarrero S, Vega-Dienstmaier J M, Saavedra J E, Sagástegui A

机构信息

Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Perú.

出版信息

Rev Neurol. 1999;28(9):876-8.

Abstract

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 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.

摘要

引言

桂利嗪是一种用于治疗眩晕症的钙通道阻滞剂药物;其最罕见的不良反应包括锥体外系症状和抑郁,这些效应在停药后可持续数周、数月或数年,其原因被解释为抑制了纹状体神经元中钙的通过以及因其与抗精神病药物相似的化学结构而具有直接的抗多巴胺能特性。临床病例。描述了一名25岁患者在治疗11天后出现桂利嗪诱发的静坐不能、帕金森综合征和抑郁的病例。使用以下工具进行了序贯评估:用于评估静坐不能的巴恩斯量表、用于评估锥体外系症状的辛普森 - 安格斯量表、贝克抑郁量表、zung抑郁量表以及根据DSM - IV标准用于评估重度抑郁的SCID。该患者接受了苯二氮䓬类药物、普萘洛尔和奥芬那君的治疗。

结论

尽管桂利嗪诱发的锥体外系症状和抑郁与老年及治疗时间延长有关,但在年轻患者中以及治疗短时间后也必须考虑其出现的可能性。

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