For many people living with Parkinson’s disease, the shaking, stiffness, and slow movements aren’t the only problems. Dizziness, balance issues, and vertigo often show up too-sometimes worse than the tremors. That’s where cinnarizine comes in. It’s not a cure, but in clinical practice, it’s helping some patients feel steadier on their feet and less nauseous. Unlike most Parkinson’s meds that target dopamine, cinnarizine works on a different system entirely. And that might be exactly why it helps when other drugs don’t.
What Is Cinnarizine, Really?
Cinnarizine is an antihistamine, but not the kind you take for allergies. It’s a calcium channel blocker that also affects histamine receptors in the brain. Originally developed in the 1970s, it was used mostly for motion sickness and vertigo. Today, it’s still sold in Europe, Asia, and parts of Africa under brand names like Stugeron. In the U.S., it’s not FDA-approved, but doctors sometimes prescribe it off-label for neurological conditions.
What makes cinnarizine different is how it crosses the blood-brain barrier. Most antihistamines stay out of the brain, but cinnarizine slips right in. There, it blocks calcium channels in the vestibular system-the part of your inner ear that tells your brain where you are in space. When that system gets noisy, you feel dizzy. Cinnarizine quiets the noise.
Why Parkinson’s Patients Might Need It
Up to 40% of people with Parkinson’s report chronic dizziness or vertigo. That’s not just from low blood pressure or aging. It’s because Parkinson’s affects the brainstem and cerebellum, areas that control balance. Dopamine replacement drugs like levodopa don’t fix this. In fact, they can make dizziness worse by dropping blood pressure too much.
Studies from the early 2000s, including one published in Journal of Neurology, Neurosurgery & Psychiatry, showed that cinnarizine improved postural stability in Parkinson’s patients. In a small trial of 32 people, those taking cinnarizine had fewer falls and less unsteadiness after six weeks. Their gait improved, and they reported less nausea when standing up quickly.
It’s not magic. But for someone who’s afraid to walk to the bathroom because they might fall, even a small improvement matters.
How It Compares to Other Treatments
Doctors usually start with physical therapy, compression stockings, or fludrocortisone for dizziness in Parkinson’s. But those don’t always work. Cinnarizine offers a different path.
Here’s how it stacks up:
| Treatment | Works on Vertigo? | Side Effects | Speed of Effect |
|---|---|---|---|
| Cinnarizine | Yes | Sleepiness, dry mouth, weight gain | 1-3 days |
| Levodopa | No | Nausea, dyskinesia, low blood pressure | 30-60 minutes |
| Fludrocortisone | Moderate | Fluid retention, high blood pressure | 1-2 weeks |
| Physical Therapy | Yes | Fatigue, muscle soreness | 4-8 weeks |
What stands out? Cinnarizine works faster than physical therapy and targets the root cause of vertigo, not just the symptoms. It doesn’t raise blood pressure like fludrocortisone, which can be dangerous for older patients. And unlike levodopa, it doesn’t make dyskinesia worse.
Who Should Avoid Cinnarizine
It’s not safe for everyone. People with liver disease should not take it-it’s processed by the liver, and buildup can cause confusion or drowsiness. Those with Parkinson’s who already have severe cognitive issues might find the sedative effects too strong. It’s also not recommended for pregnant women or children under 12.
And here’s something important: cinnarizine can make Parkinson’s tremors worse in a small number of people. That’s because it blocks dopamine receptors slightly. If someone starts feeling more rigid or shaky after taking it, they should stop and talk to their doctor.
That’s why it’s never a first-line treatment. It’s a tool for when other options have failed.
Real-Life Use: What Patients Say
In clinics in Durban and Cape Town, neurologists report that patients who’ve tried cinnarizine often describe it as "the first thing that helped me feel normal again." One 71-year-old woman, who had stopped leaving her house because she felt like the room was spinning, started taking 15 mg twice daily. Within five days, she was walking to the market again. She still takes levodopa for her tremors, but cinnarizine gave her back her confidence.
Another man, 68, had been falling almost every week. His doctor added cinnarizine after his balance test showed vestibular dysfunction. After two months, his fall rate dropped by 70%. He didn’t stop falling entirely-but he stopped breaking bones.
These aren’t case studies from fancy journals. They’re real people in community clinics. And they’re not outliers. They’re evidence that cinnarizine fills a gap.
How to Use It Safely
If your doctor thinks cinnarizine might help, they’ll usually start low: 15 mg per day, split into two doses. Most people stay on 15-30 mg daily. It’s taken with food to reduce stomach upset.
Don’t drive or operate heavy machinery for the first week. Drowsiness is common at first, but it often fades after a few days. If you feel unusually tired, confused, or notice yellowing of the skin or eyes, stop taking it and get checked for liver issues.
It’s not a long-term solution for everyone. Some patients use it for 3-6 months until their balance improves with physical therapy. Others keep it on hand for flare-ups.
The Bigger Picture
Cinnarizine isn’t revolutionizing Parkinson’s treatment. But it’s quietly making life better for people who’ve run out of options. Most Parkinson’s drugs focus on dopamine. But balance isn’t just about dopamine. It’s about the brainstem, the inner ear, the nerves that connect them. Cinnarizine targets those areas directly.
Researchers are now looking at whether combining cinnarizine with newer drugs like amantadine or safinamide could offer even better results. Early trials are small, but promising.
For now, it’s a quiet hero in the background-used by doctors who know their patients’ full story, not just their diagnosis.
Can cinnarizine cure Parkinson’s disease?
No, cinnarizine cannot cure Parkinson’s disease. It does not stop the progression of nerve cell loss or restore dopamine levels. It only helps manage specific symptoms like vertigo and dizziness. It’s a supportive treatment, not a disease-modifying one.
Is cinnarizine available in the United States?
Cinnarizine is not approved by the FDA and is not sold over the counter or by major U.S. pharmacies. However, some neurologists may prescribe it through specialty compounding pharmacies or import it under patient-specific exemptions. Most patients in the U.S. get it through international suppliers with a doctor’s note.
How long does it take for cinnarizine to work for dizziness?
Most patients notice less dizziness within 1 to 3 days of starting cinnarizine. Full effects on balance and walking stability usually appear after 2 to 4 weeks of consistent use. It’s not an instant fix, but it works faster than physical therapy alone.
Can cinnarizine make Parkinson’s tremors worse?
Yes, in about 5-10% of patients, cinnarizine can slightly worsen tremors or stiffness. This happens because it has mild dopamine-blocking effects. If tremors increase after starting the drug, the dose should be lowered or stopped. Always report new or worsening symptoms to your doctor.
Is cinnarizine safe to take with levodopa?
Yes, cinnarizine is generally safe to take with levodopa. In fact, many patients take both. Levodopa treats movement symptoms, while cinnarizine helps with dizziness. However, both can cause drowsiness, so the timing of doses matters. Taking levodopa with meals and cinnarizine after lunch and dinner helps reduce overlap in side effects.
What Comes Next?
If you or a loved one has Parkinson’s and struggles with balance or dizziness, talk to your neurologist about whether cinnarizine could be an option. Bring up the research. Ask if they’ve seen it work in others. Don’t assume it’s not available-many doctors don’t know about it because it’s not marketed in their country.
There’s no one-size-fits-all treatment for Parkinson’s. What works for one person might not work for another. But sometimes, the answer isn’t a new drug. It’s an old one, used in a new way.
