Effect of functional NMDA-antagonist flupirtine on automatic postural responses in Parkinson's disease

Abstract

Animal studies have demonstrated potent antiparkinsonian and other motor effects of the functional NMDA-antagonist flupirtine and suggest a therapeutic use in Parkinson's disease (PD). In healthy subjects flupirtine decreases the functionally destabilizing medium latency (ML) response following toe-up rotations of a moving platform. Because ML responses are known to be increased in PD, this study examined s the effects of flupirtine on postural responses in patients with PD. During 22 days 21 patients with PD took 50 mg, 100 mg flupirtine or placebo following a randomized, double-blind design. Clinical impairment was assessed by means of the Unified Parkinson's Disease Rating Scale (UPDRS). No significant difference between the effect of flupirtine and placebo on ML responses was observed. There was an unspecific improvement of overall UPDRS scores in placebo and flupirtine conditions compared with baseline measures which was more marked in the placebo condition. No improvement in the UPDRS motor subscale was observed. As no beneficial effect on the clinical presentation and no effect on postural responses could be demonstrated, flupirtine does not seem to be a therapeutic option in PD.

Falls in Parkinson's disease

“…This was the topic of two trials. The first was a double-blind and placebo-controlled study of flupirtine, a functional antagonist of N-methyl-D-aspartate with a confirmed influence on automatic postural responses in healthy individuals [57]. A single dose of 50 or 100 mg flupirtine failed to improve automatic postural responses to sudden tilts of a supporting platform.…”

Flupirtine is a safe alternative drug in patients with hypersensitivity to NSAIDs

“…[6] Antiparkinsonian and other motor effects relying on its NMDA-antagonistic effects were demonstrated. [7] Most frequent ADR in flupirtine treated patients (n=110; 3x 100mg/day) were vertigo (13%) and nausea (9%), but rates of these ADR were significantly lower than in a control group treated with tramadol (n=110) [8]. There are no studies on its long term cerebro-or cardiovascular effects.…”

Schmerzen und Missempfindungen bei Parkinson-Patienten

“…(60). Experimentelle Daten sprechen für einen diskreten spezifischen antiparkinsonoiden und Levodopa-potenzierenden Effekt des NMDA-Antagonisten Flupirtin (43,48,51).…”