A Unique case of Flunarizine Induced Extrapyramidal Syndrome and Depression

Abstract

Flunarizine is one the cerebroselective calcium channel blocker, commonly prescribed for migraine prophylaxis in neurology clinic. It is considered as non inferior to propranolol and amytriptyline to reduce the frequency of migraine attacks. Here we report a case flunarizine induced extrapyramidal syndrome and depression. A 37 year old female on tablet flunarzine 15 mg daily for her migraine signs of depression and restlessness, propensity to bend, slow reactions and mask face. Depression was rated using patient health questionnaire and extrapyramidal syndrome was diagnosed by modified simpson agnus scale and Barnes akathisia rating scale. Considering nil organic lesion and improvment of all symptoms with the cessation of flunrarizine, case was diagnosed as flunarizine induced depression and extrapyramidal disorder.