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Calcium channel blockers

Category: Medicines

Type

Involuntary

Introduction and description

Clinically, the most widespread use of calcium channel blockers is to decrease blood pressure in patients with hypertension, particularly the elderly, as well as to control heart rate, and reduce chest pain due to angina pectoris.

With a lowered blood pressure, the load on the heart decreases; this decreases how hard the heart must work to eject blood into the aorta, and so the amount of oxygen required by the heart decreases accordingly. This is what helps the angina pectoris. And this is the theory.

One of the complexities of calcium channel blockers however is that unlike beta-blockers, calcium channel blockers do not decrease the responsiveness of the heart to input from the sympathetic nervous system. Blood pressure regulation is carried out by the sympathetic nervous system, so once the calcium channel blockers decrease the blood pressure, the sympathetic nervous system can initiate an increase! So some doctors treating heart problems may prescribe a beta-blocker as well as a calcium channel blocker.

And they cause a lot of hallucinations.

Background

This class of drugs is not without its problems.

Meyler

Meyler’s Side effects of Drugs has over 12 pages devoted to the side effects of calcium channel blockers. The headings cover myocardial failure [heart failure] disturbances of cardiac rhythm, Ischemic chest pain, pulmonary hypertension, transient cerebral ischemia with aphasia and hemiparesis, cerebellar dysfunction, loss of consciousness, transient retinal ischemia, hyperactivity, fasciculation, paresthesia, myclonic dystonia, respiratory failure, menorrhagia, gynecomastia, hypokalemia, rises in serum alkaline phosphatase, agraulocytosis, leucopenia, mild hepatic reactions, constipation, renal dysfunction, diuresis, nocturia, painful coldness and numbness, rashes, oedema, erythema multiforme, Steven-Johnson’s syndrome, flushing, leg erythemadermatitis, psoriasis, dyosmia, dysgeusia, muscle cramps, gingivitus, headaches, and so it goes on!

One really interesting side effect is Parkinsonism. There are a lot of elderly people with high blood pressure who have been diagnosed with Parkinson’s disease – I know a few - perhaps they haven’t got Parkinson’s disease at all, they’re being over dosed on calcium channel blockers!

Perhaps one of the most ironic statements I found in the recommendations of risks to be avoided is that these drugs shouldn’t be used if you have cardiomyopathy. Now cardiomyopathy literally means "heart muscle disease," and describes the deterioration of the function of the myocardium (i.e., the actual heart muscle) for any reason. So we have people whose heart is no longer working too well, being told not to use drugs designed for people whose hearts are not working too well. Sorry for my cynicism here!

Finally at high doses CCBs block the effect of insulin.

According to eHealthme

Taking one example drug - Amlodipine - and using the ADRs submitted by doctors to SEDA and the FDA and published on eHealthme, the most common Amlodipine side effects are :

Nausea (2,143 reports)
Weakness (2,123 reports)
Breathing Difficulty (1,994 reports)
High Blood Pressure (1,990 reports)
Hypotension (1,892 reports)
Fatigue (1,813 reports)
Dizziness (1,783 reports)
Fever (1,701 reports)
Diarrhea (1,632 reports)
Renal Failure Acute (1,547 reports)

and

Most common side effects by gender :

Female	Male
Nausea	Myocardial Infarction
Dizziness	Pain
Oedema Peripheral	Nausea
Dyspnoea	Dyspnoea
Fall	Drug Ineffective
Fatigue	Oedema Peripheral
Chest Pain	Fatigue
Pain	Pyrexia
Asthenia	Chest Pain
Drug Ineffective	Asthenia

Death

Again using the ADRs from eHealthme, we have the following snapshot of the ultimate spiritual experience - death.

Amlopidine under the names

Amlopidine - On Aug, 25, 2015: 45,031 people reported to have side effects when taking Amlodipine. Among them, 721 people (1.60%) have Death
Norvasc - On Aug, 12, 2015: 79,032 people reported to have side effects when taking Norvasc. Among them, 1,898 people (2.40%) have Death
Lotrel - On Aug, 12, 2015: 9,254 people reported to have side effects when taking Lotrel. Among them, 158 people (1.71%) have Death.

Felodipine under the names

Felodipine - On Aug, 25, 2015: 6,908 people reported to have side effects when taking Felodipine. Among them, 82 people (1.19%) have Death
Plendil - On Aug, 25, 2015: 3,998 people reported to have side effects when taking Plendil. Among them, 58 people (1.45%) have Death

Nicardipine under the names

Nicardipine hydrochloride - On Aug, 25, 2015: 1,437 people reported to have side effects when taking Nicardipine hydrochloride. Among them, 22 people (1.53%) have Death
Cardene - On Jul, 28, 2015: 527 people reported to have side effects when taking Cardene. Among them, 18 people (3.42%) have Death

Nifedipine and all its variant trade names

Nifedipine - On Aug, 25, 2015: 17,332 people reported to have side effects when taking Nifedipine. Among them, 362 people (2.09%) have Death
Adalat - On Aug, 25, 2015: 12,827 people reported to have side effects when taking Adalat. Among them, 223 people (1.74%) have Death
Procardia - On Aug, 18, 2015: 10,581 people reported to have side effects when taking Procardia. Among them, 233 people (2.20%) have Death
Procardia xl - On Aug, 25, 2015: 4,903 people reported to have side effects when taking Procardia xl. Among them, 94 people (1.92%) have Death
Adalat cc - On Jul, 31, 2015: 3,231 people reported to have side effects when taking Adalat cc. Among them, 74 people (2.29%) have Death

Verapamil under the names

On Aug, 25, 2015: 2,299 people reported to have side effects when taking Verapamil hcl. Among them, 57 people (2.48%) have Death
On Aug, 6, 2015: 2,666 people reported to have side effects when taking Verapamil hydrochloride. Among them, 32 people (1.20%) have Death
On Aug, 10, 2015: 2,851 people reported to have side effects when taking Calan. Among them, 38 people (1.33%) have Death

Isoptin under the names

On Jul, 30, 2015: 3,720 people reported to have side effects when taking Isoptin. Among them, 52 people (1.40%) have Death
On Aug, 4, 2015: 662 people reported to have side effects when taking Isoptin sr. Among them, 6 people (0.91%) have Death

Diltiazem under the names

On Aug, 25, 2015: 6,081 people reported to have side effects when taking Diltiazem hydrochloride. Among them, 59 people (0.97%) have Death
On Jul, 26, 2015: 3,044 people reported to have side effects when taking Tiazac. Among them, 61 people (2.00%) have Death

Cardizem under the names

On Jul, 27, 2015: 15,974 people reported to have side effects when taking Cardizem. Among them, 352 people (2.20%) have Death
On Aug, 8, 2015: 3,393 people reported to have side effects when taking Cardizem cd. Among them, 69 people (2.03%) have Death
On Aug, 24, 2015: 425 people reported to have side effects when taking Cardizem la. Among them, 10 people (2.35%) have Death
On Aug, 1, 2015: 155 people reported to have side effects when taking Cardizem sr. Among them, 2 people (1.29%) have Death

How it works

Calcium channel blockers ‘work’ to give you hallucinations through hypoxia produced by ion channel blocking – If you have too much of these drugs, in effect you over-dose whether deliberately or accidentally it can lead to hypotension, low blood pressure.

Hypotension may then lead to hypoxia, which in turn leads to the mind shutting down the reasoning function and memory as a first line of protection against the system failing, principally because reasoning and memory require considerable supplies of energy and that energy is needed to keep you alive in other areas!

If you thus overdose accidentally or on purpose with these class of drugs you get hypoxia induced spiritual experience, although it may be a none too pleasant one.

Observations

The following products are all classified as Calcium channel blockers of the heart. The number of involuntary hallucinations produced by the drugs is shown below and was derived from SEDA figures found on the eHealthme web site. It was correct as at 2010. The link takes you to the eHealthme website where an up to date figure for the hallucinations and a list of all side-effects can be found. All the products listed are licensed drugs.

The CCB class is easily identified by the suffix. The Dihydropyridines have the suffix "-dipine"; the Phenylalkylamines have the suffix "-pamil" and the 1-4 Benzothiazepines have the suffix "-tiazem".

The following table provides a summary of the number of hallucinations from each observation

Observation no	Drug Name	No of hallucinations
005111	Amlodipine [213] Norvasc [213]	213
005111	Amlodipine/benazepril, marketed in the U.S. as Lotrel	20
005111	Felodipine (Plendil]	30
005111	Nicardipine (Cardene, Carden SR)	10
005111	Nifedipine brand names Adalat, Nifediac, Nifedical, and Procardia	111
005112	Verapamil Calan,	49
005112	Isoptin	25
005113	Diltiazem - trade name Tiazac	90
005113	Cardizem	145
		693

The following have not been categorised. None has a record of hallucinations that I could find at the time of first doing this entry in 2012. If this changes then an observation will be added :

Amrinone; Azimilide; Bencyclane; Berbamine; Bevantolol [a drug which acts as both a beta blocker and a calcium channel blocker]; Canadine; Carboxyamidotriazole; Cinnarizine; Dauricine [ is the main toxin that makes the North American vine Menispermum canadense (moonseed) poisonous (often fatally so) ]; Dimeditiapramine; Dotarizine; Enpiperate; Fantofarone; Fostedil; Manoalide ; Mibefradil; Monatepil; Niguldipine; Osthol is found in the plants Cnidium monnieri and Angelica pubescens]; Prenylamine ; Sesamodil ; Tetrandrine [ isolated from Stephania tetandra and other Chinese and Japanese Herbs] .

Related observations

Therapeutics Education Collaboration - Bohemian Polypharmacy 012489

Danielou, Alain – On drugs you are possessed by the spirit being of the drug 022582

The Toxicology Investigators Consortium Case Registry--the 2012 experience 015593

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Calcium channel blockers

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