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Flunarizine+Keppra old post question


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Hi!! 

 

I did not write that post but it inspired me to try Keppra. I started out just a few days ago.  Right now I'm on 250mg morning and evening which will be increased to 500mg morning and evening after 2 weeks. 

All I can say right now is that I'm feeling really tired and a bit weird (more than usual) from the medicine. However I know that medicine like this takes a few weeks to get used to and I will try it out for at least a total om 1 month if I don't get any other serious side effects. I also heard that the drowsiness is suppose to be reduced after taking it for a while. 

Had Hppd for 1.5 year now and it just got worse after traveling abroad for 2 weeks, which was why I called my neurologist and asked him to prescribe this for me. Feels kind of shitty when things practically reset after 1.5 years of trying to get better huh? 

 

I can update here on how it all went in a couple of months. 

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  • 4 years later...
On 6/24/2018 at 8:14 AM, olivier24445 said:

sure. 

About Flunarizine, it seems that it's very risky (Parkinson...) so, bad idea...

It’s not Parkinson’s. It’s parkinsomism.

 

Introduction

Cinnarizine (CNZ) and flunarizine (FNZ) belong to the calcium channel blockers class of medication.

Main text

The aim of this literature review is to evaluate the clinical epidemiological profile, pathological mechanisms, and management of CNZ/FNZ-associated movement disorder (MD). Relevant reports in six databases were identified and assessed by two reviewers without language restriction. One hundred and seventeen reports containing 1920 individuals who developed a CNZ/FNZ-associated MD were identified. The MD encountered were 1251 parkinsonism, 23 dyskinesias, 11 akathisia, 16 dystonia, and 5 myoclonus, and in the group not clearly defined, 592 extrapyramidal symptoms, 19 tremors, 2 bradykinesia, and 1 myokymia. The predominant sex was female with a percentage of 72.69% (466/641). The mean age was 74.49 (SD, 7.88) years. The mean CNZ dose was 148.19 mg (SD, 42.51) and for the FNZ dose, 11.22 mg (5.39). The mean MD onset and recovery were 1.83 years (SD, 1.35) and 3.71 months (SD, 1.26). In the subgroup of subjects that had improvement of the symptoms, the complete recovery was achieved within 6 months of the drug withdrawal in almost all subjects (99%). The most common management was drug withdrawal. A complete recovery was observed in 93.77% of the patients (437/466).

 

https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00197-w

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Here is a population study. This drug is certainly not without risk but it is good to know what those risk % are and what it means if they happen. 
 

Background: Flunarizine (Fz) is a first-line prophylactic medication that is widely used in migraine. However, Fz has been recognized as a potential cause of drug-induced parkinsonism for a long time. However, to our knowledge, there has been no population-based subgroup analyses for Fz-induced parkinsonism (FIP) in migraine patients.

Methods: Data were obtained from the Taiwan’s National Health Insurance Research Database. The study comprised 6,470 migraine patients who were divided into two groups, based on their exposure or non-exposure to Fz.

Results: During the study period (2000–2012), the incidence rate of parkinsonism was 1.92 and 8.72 per 1,000 person-years in the control and Fz -treated groups, respectively. In the study population, the adjusted hazard ratio was 4.07 (95% confidence interval CI: 2.84–5.85). In 45–64-year old subjects and ≥ 65-year old subjects, the risk of FIP was 3.18 times (95% CI = 1.63–6.20) and 4.89 times (95% CI = 3.09–7.72) more than that in the controls. The Fz-treated subjects with comorbidities also had a higher risk (4.54, 95% CI: 3.14-6.57). An average annual cumulative Fz dose > 445 mg was accompanied by the greatest risk of FIP; Fz use for >60 days is a cut-off point for predicting future FIP.

Conclusion: At the population level, this study showed a complete picture of FIP in migraine patients. FIP is associated with older age, history of comorbidities, exposure to high-dose of Fz, and longer duration of exposure to Fz.

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