Objective: The calcium channel blockers, such as flunarizine and cinnarizine, and rarely selective serotonin reuptake inhibitors and lithium can produce parkinsonism and tardive syndromes.

Background: Drug-induced movement disorders include drug-induced parkinsonism (DIP), tardive dyskinesia (TD), tardive dystonia, akathisia, myoclonus, and tremor. Flunarizine is one of the most common drugs that cause the DIP.

Methods: We use the Taiwan National Health Insurance Research Database of cases fulfilling diagnostic codes of all the flunarizine exposed patient (age between 20-90 years old) and Parkinsonism in Taiwan between 2000 and 2006 without adding additional data. We conducted descriptive analyses and compared the differences between the two groups.

Results: We identified 4111 flunarizine induced parkinsonism (FIP) patients with a female and male (2:1) distribution (65.2% vs. 34.8%). The mean age was 56.5 years, and most of the patients were between 20 and 90 years old. The highest hazard ratio (HR) of cumulative Flunarizine dosage and cumulative flunarizine day are over 2g (HR: 6.66, P<0.001) and >240 days (HR: 6.51, p<0.001) respectively. There was no difference between sexes and comorbidity status. The cumulative incidence after flunarizine exposure after 12 years follow-up time is significantly higher than non-flunarizine group (incidence 37% vs. 5%, p<0.001).

Conclusions: Some important findings, including higher percentages of FIP in longer cumulative exposure days and dosage in patients exposed to flunarizine. The study may help developing strategies for prevention and epidemiology of FIP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/demographic-and-clinical-characteristics-of-flunarizine-induced-parkinsonism-nationwide-data-between-2000-and-2006-in-taiwan/