Calcium antagonists in Parkinson’s disease

Calcium antagonists should not be used in people with Parkinson’s disease. Research has shown that certain members of this group of drugs can worsen the symptoms typical of the disease. However, there are also studies that suggest that a particular calcium channel blocker may have a positive effect on the course of PD. Due to this (still) ambiguous study situation, calcium antagonists should generally not be used in people with Parkinson’s disease until new research findings are obtained.

Different types of calcium antagonists

This group of drugs can be divided into three further subgroups, which exert their effect at different locations (heart muscle, stimulus-conduction system, vessels): The group of phenylalkylamines, benzothiazepines and dihydropyridines. The groups of calcium antagonists: The column “Name of the preparation” contains the names of the pharmaceutical companies for their drugs with a special active substance from the group of calcium antagonists.

Active ingredient name | active ingredient group | active ingredient location | preparation name
Nifedipine | dihydropyridines | vessel walls | e.g.
Adalat®, Aprical®
Nitrendipine | dihydropyridines | vessel walls | e.g. Bayotensin®, Nitrepress®
Amlodipine | dihydropyridine | vessel walls | e.g. Norvasc®, Amlobeta®
Felodipine | dihydropyridine | vessel walls | e.g.
Felocor®, Modip®
Verapamil | phenylalkylamines | heart and vessel walls | e.g. Cardioprotect®, Ispotin®
Diltiazem | benzothiazepines | heart and vessel walls | e.g. Dilsal®, Diltiuc®

The vessel walls are the main site of action of dihydropyridines (DHP): they reduce vascular resistance and thus lower blood pressure. When DHP is taken, the heartbeat can become faster (tachycardia) because the nervous system reacts reflexively to the decrease in blood pressure.

Dihydropyridines are mainly used in the treatment of high blood pressure. The subgroup of phenylalkylamines acts both on the heart and the vessels. The heartbeat slows down and the beating power of the heart decreases.

The resistance of the vessels also decreases. Both mechanisms cause a reduction of blood pressure in the patient. Unlike dihydropyridines, the heartbeat does not become faster because the drug’s action cancels out the reaction of the nervous system.

Phenylalkylamines are used in the treatment of high blood pressure and cardiac arrhythmia. Benzothiazepines have similar effects compared to phenylalkylamines, but they only slightly reduce the strength of the heartbeat. An advantage of the group of drugs is that they do not affect metabolic functions and therefore do not cause an increase or decrease in blood sugar levels and the like. Benzothiazepines are used when a patient is suffering from cardiac arrhythmia.