[Extrapyramidal syndrome during treatment with flunarizine]

A 68 year-old woman had been taking flunarizine 10 mg daily for 10 weeks when she developed severe bradykinesia and rigidity, resting tremor of both hands, akathisia, buccolinguofacial dyskinesias and depressed mood. Flunarizine was discontinued. After 3 months the patient was asymptomatic. This case and data from the literature suggest that extrapyramidal symptoms and depression may be observed even at the recommended daily dose of 10 mg. Flunarizine should be avoided in patients with Parkinson's disease. Patients on flunarizine should be watched for depressive and extrapyramidal signs, especially those aged over 60.