Respiratory Alkalosis as an Adverse Effect of Safinamide?

Respiratory alkalosis is associated with central nervous system (CNS) diseases, drugs, lung diseases and others. Safinamide is a recent anti-parkinsonian drug with anti-dyskinetic properties and a good adjunct to L-dopa therapy during the activation period, with no significant adverse effects described. The authors present a case of a 71-year-old woman, with Parkinson's disease treated with levodopa/benserazide, safinamide, amitriptyline, sertraline and diazepam. She made multiple visits to the emergency department due to progressive dyspnoea and asthenia, with primary respiratory alkalosis, which was thought to be caused by anxiety-induced hyperventilation and treated accordingly. After a comprehensive study, it was determined that the most probable cause of the respiratory alkalosis was pharmacological. There was a clinical and temporal agreement with the introduction of safinamide. LEARNING POINTS: Respiratory alkalosis is a multifactorial acid-base disorder, mostly associated with psychological factors and anxiety induced hyperventilation.Safinamide is a new drug for the treatment of Parkinson's disease with promising results in terms of efficacy and safety. However, there is only a limited number of studies on safinamide.Respiratory alkalosis could be an adverse effect of safinamide through several different mechanisms.