Flunarizine Induced Parkinsonism in Migraine Group: A Nationwide Population-Based Study

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Title:	Flunarizine Induced Parkinsonism in Migraine Group: A Nationwide Population-Based Study
Authors:	Lin, W (Lin, Wei) Lin, CL (Lin, Cheng-Li) Hsu, CY (Hsu, Chung Y.) Wei, CY (Wei, Cheng-Yu)
Contributors:	運健系
Keywords:	flunarizine parkinsonism drug-induced parkinsonism migraine population-based
Date:	2019-12-19
Issue Date:	2020-01-20 13:48:37 (UTC+8)
Abstract:	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.
Relation:	FRONTIERS IN PHARMACOLOGY 卷冊: 10 文獻號碼: 1495
Appears in Collections:	[Department of Exercise and Health Promotion] journal articles

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