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Trimetazidine-Induced Parkinsonism: A Systematic Review
Anna Marielle B Dy1,2, Lorenzo Luis G Limjoco3, Roland Dominic G Jamora2,4,5
1Department of Clinical Neurosciences, University of the East Ramon Magsaysay Memorial Medical Center, Inc., Quezon City, Philippines.
Frontiers in Neurology
|March 12, 2020
Summary
Trimetazidine (TMZ) can cause parkinsonism, a reversible condition. This systematic review found that withdrawing TMZ led to symptom improvement in all patients, with over half experiencing complete recovery.
Area of Science:
- Neurology
- Pharmacology
Background:
- Trimetazidine (TMZ) is prescribed for stable coronary artery disease.
- Increasing reports link TMZ to adverse events like parkinsonism.
Approach:
- Systematic literature review of studies on TMZ-induced parkinsonism.
- Included case reports, series, retrospective, and prospective studies up to November 2019.
Key Points:
- Reviewed five studies involving 88 patients with TMZ-induced parkinsonism.
- Parkinsonian symptoms (akinesia, rigidity, gait issues) resolved after TMZ withdrawal.
- 55.7% had complete symptom regression; 44.3% had significant improvement.
Conclusions:
- TMZ can induce reversible parkinsonism, particularly in the elderly.
- Clinical vigilance for parkinsonian symptoms in patients on TMZ is warranted.
- Further research needed on TMZ's risk-benefit ratio, especially in elderly populations.
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