english.prescrire.org > Spotlight > Archives : 2009 > Trimetazidine: unfavourable risk-benefit balance increasingly confirmed

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Trimetazidine: unfavourable risk-benefit balance increasingly confirmed

Trimetazidine is still on the market as a treatment for various disorders, even though its efficacy is unproven and it can cause sometimes severe adverse neurological effects.

Since 1965, trimetazidine has been marketed for indications ranging from angina pectoris to visual and auditory disorders and vertigo, with no proven benefit for patients.

We may well ask why trimetazidine is still available, when it was established several years ago that it can cause sometimes severe Parkinsonian-type adverse effects.

New evidence confirms the seriousness of these adverse effects. A team from Caen has reported that one week after starting treatment with trimetazidine for a sight disorder, a patient suffered from a range of symptoms: abnormal movements, impaired vigilance, restless legs, visual hallucinations, and shaking. All of these symptoms vanished after treatment was halted.

The Amiens regional pharmacovigilance centre analysed 10 reports of Parkinsonian-type effects associated with trimetazidine. After halting treatment, the effects vanished in 7 cases, but in 3 other patients, the regression was only partial.

In the absence of any proven benefit, nothing justifies exposing patients to such severe adverse effects.

©Prescrire June 2009

Source: "Effets indésirables extrapyramidaux de trimétazidine" Rev Prescrire 2008; 28 (301); 833.

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