Extrapyramidal adverse drug reactions associated with trimetazidine: a series of 21 cases.
Identifieur interne : 000809 ( PubMed/Checkpoint ); précédent : 000808; suivant : 000810Extrapyramidal adverse drug reactions associated with trimetazidine: a series of 21 cases.
Auteurs : Kamel Masmoudi [France] ; Henri Masson ; Valérie Gras ; Michel AndréjakSource :
- Fundamental & clinical pharmacology [ 1472-8206 ] ; 2012.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Trimetazidine, Vasodilator Agents.
- chemically induced : Basal Ganglia Diseases, Parkinson Disease, Secondary.
- etiology : Akathisia, Drug-Induced.
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged.
Abstract
Over the last few years, a number of cases of extrapyramidal disorders associated with trimetazidine (TMZ) use has been reported. Here, we report on a series of 21 cases. All but one of the patients (mean age 74) had been taking TMZ for several years. The indication for prescription of TMZ could not be identified in seven cases. The TMZ-associated adverse drug reactions were typical parkinsonism (akinesia and/or rigidity and/or rest tremor) in 17 cases, gait disorders in three cases (one with orthostatic tremor), and restless leg syndrome in one case. Discontinuation of TMZ led to complete disappearance of the symptoms in 16 cases and a significant reduction in the five other patients. TMZ has the same piperazine core as the dopamine antagonists flunarizine and cinnarizine (both of which have been reported to induce extrapyramidal symptoms). Hence, striatal D2 receptor blockade could result in the onset or the worsening of extrapyramidal disorders. Even though this adverse drug reaction is now listed in TMZ's Summary of Product Characteristics (because of the initial reports), the risk remains poorly known by clinicians. There is a need to raise awareness of this phenomenon and to reassess TMZ 's risk-benefit ration, especially in the elderly.
DOI: 10.1111/j.1472-8206.2011.01008.x
PubMed: 22044594
Affiliations:
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Here, we report on a series of 21 cases. All but one of the patients (mean age 74) had been taking TMZ for several years. The indication for prescription of TMZ could not be identified in seven cases. The TMZ-associated adverse drug reactions were typical parkinsonism (akinesia and/or rigidity and/or rest tremor) in 17 cases, gait disorders in three cases (one with orthostatic tremor), and restless leg syndrome in one case. Discontinuation of TMZ led to complete disappearance of the symptoms in 16 cases and a significant reduction in the five other patients. TMZ has the same piperazine core as the dopamine antagonists flunarizine and cinnarizine (both of which have been reported to induce extrapyramidal symptoms). Hence, striatal D2 receptor blockade could result in the onset or the worsening of extrapyramidal disorders. Even though this adverse drug reaction is now listed in TMZ's Summary of Product Characteristics (because of the initial reports), the risk remains poorly known by clinicians. There is a need to raise awareness of this phenomenon and to reassess TMZ 's risk-benefit ration, especially in the elderly.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22044594</PMID><DateCreated><Year>2012</Year><Month>03</Month><Day>07</Day></DateCreated><DateCompleted><Year>2012</Year><Month>07</Month><Day>09</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1472-8206</ISSN><JournalIssue CitedMedium="Internet"><Volume>26</Volume><Issue>2</Issue><PubDate><Year>2012</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Fundamental & clinical pharmacology</Title><ISOAbbreviation>Fundam Clin Pharmacol</ISOAbbreviation></Journal><ArticleTitle>Extrapyramidal adverse drug reactions associated with trimetazidine: a series of 21 cases.</ArticleTitle><Pagination><MedlinePgn>198-203</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/j.1472-8206.2011.01008.x</ELocationID><Abstract><AbstractText>Over the last few years, a number of cases of extrapyramidal disorders associated with trimetazidine (TMZ) use has been reported. Here, we report on a series of 21 cases. All but one of the patients (mean age 74) had been taking TMZ for several years. The indication for prescription of TMZ could not be identified in seven cases. The TMZ-associated adverse drug reactions were typical parkinsonism (akinesia and/or rigidity and/or rest tremor) in 17 cases, gait disorders in three cases (one with orthostatic tremor), and restless leg syndrome in one case. Discontinuation of TMZ led to complete disappearance of the symptoms in 16 cases and a significant reduction in the five other patients. TMZ has the same piperazine core as the dopamine antagonists flunarizine and cinnarizine (both of which have been reported to induce extrapyramidal symptoms). Hence, striatal D2 receptor blockade could result in the onset or the worsening of extrapyramidal disorders. Even though this adverse drug reaction is now listed in TMZ's Summary of Product Characteristics (because of the initial reports), the risk remains poorly known by clinicians. There is a need to raise awareness of this phenomenon and to reassess TMZ 's risk-benefit ration, especially in the elderly.</AbstractText><CopyrightInformation>© 2011 The Authors Fundamental and Clinical Pharmacology © 2011 Société Française de Pharmacologie et de Thérapeutique.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Masmoudi</LastName><ForeName>Kamel</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Unité de Neurologie-Neuropharmacovigilance, Service de Pharmacologie Clinique, CHU Amiens, France. masmoudi.kamel@chu-amiens.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Masson</LastName><ForeName>Henri</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Gras</LastName><ForeName>Valérie</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Andréjak</LastName><ForeName>Michel</ForeName><Initials>M</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>11</Month><Day>02</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Fundam Clin Pharmacol</MedlineTA><NlmUniqueID>8710411</NlmUniqueID><ISSNLinking>0767-3981</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014665">Vasodilator Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>N9A0A0R9S8</RegistryNumber><NameOfSubstance UI="D014292">Trimetazidine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017109" MajorTopicYN="N">Akathisia, Drug-Induced</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001480" MajorTopicYN="N">Basal Ganglia Diseases</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="Y">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010302" MajorTopicYN="N">Parkinson Disease, Secondary</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014292" MajorTopicYN="N">Trimetazidine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014665" MajorTopicYN="N">Vasodilator Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>11</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>11</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2012</Year><Month>7</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">22044594</ArticleId><ArticleId IdType="doi">10.1111/j.1472-8206.2011.01008.x</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country></list><tree><noCountry><name sortKey="Andrejak, Michel" sort="Andrejak, Michel" uniqKey="Andrejak M" first="Michel" last="Andréjak">Michel Andréjak</name><name sortKey="Gras, Valerie" sort="Gras, Valerie" uniqKey="Gras V" first="Valérie" last="Gras">Valérie Gras</name><name sortKey="Masson, Henri" sort="Masson, Henri" uniqKey="Masson H" first="Henri" last="Masson">Henri Masson</name></noCountry><country name="France"><noRegion><name sortKey="Masmoudi, Kamel" sort="Masmoudi, Kamel" uniqKey="Masmoudi K" first="Kamel" last="Masmoudi">Kamel Masmoudi</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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