The Classification of Calcium Antagonists by the WHO Expert Committee: Relevance in Neurology

A new classification of calcium antagonists has been developed by a WHO expert committee. Substances acting primarily via the inhibition of calcium entry into the cell have been divided into four distinct classes. The pharmacological characteristics of these classes that may be relevant for the use in various neurological disorders are highlighted in this paper. Some main differences concern the effects on vascular smooth muscle cells and brain cells. The well-documented clinical applications in neurology are still limited to migraine prophylaxis and vertigo. The evidence concerning the usefulness in cerebral vasospasm secondary to subarachnoid haemorrhage was regarded as reasonable, whereas several neurological indications should still be regarded as being under examination. There is little doubt that calcium antagonists will gain importance in the treatment of several neurological diseases.