Trimetazidine withdrawal syndrome

Introduction: TRIMETAZIDINE (T) modifi es the myocardial metabolism, glucose being used preferentially instead of FFA. As a consequence, ischemic local acidosis is alleviated. Myocardium is not isolately affected: some patients may develop Parkinsonism. Aim of the study: description of the T withdrawal syndrome. Methods: Aft er the first case was published, a cohort of 84 cases was prospectively studied. All the patients ingested T regularly for more than one year, then the administration of T was abruptly stopped. Symptoms were recorded, clinical examination and ECG. Results: 7 patients (5F, 2M) complained of discomfort/ pain in anterothoracic area, dominant retrosternal. Associated symptoms: insomnia, restlessness, anxiety, prompt remission following T re-administration or spontaneously within a few days. Some patients refused to give up T because ”they feel better with this drug” (dependency?). Conclusions: If T administration is suddenly stopped after long term use, some patients develop a withdrawal syndrome dominated by discomfort and pain in the precordial area, associated with anxiety, restlessness and insomnia.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)