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Comparison of the Efficacy and Safety of Flunarizine to Propranolol in the Prophylaxis of Migraine

Published online by Cambridge University Press:  18 September 2015

M.J. Gawel ,
J. Kreeft ,
R.F. Nelson ,
D. Simard  and
W.S. Arnott
M.J. Gawel*
Affiliation:
Division of Neurology, Sunnybrook Health Sciences Centre, Toronto
J. Kreeft
Affiliation:
Headache Clinic, Victoria Hospital, London
R.F. Nelson
Affiliation:
Division of Neurology, Ottawa General Hospital, Ottawa
D. Simard
Affiliation:
Department of Neurology, Hôpital de l’Enfant-Jésus, Québec City
W.S. Arnott
Affiliation:
Research and Development, Janssen Pharmaceutica Inc., Mississauga
*
Sunnybrook Health Sciences Centre, Room E425, 2075 Bayview Avenue, Toronto, Ontario, Canada
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Abstract:

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This study was designed to compare flunarizine, a cerebro-specific calcium channel antagonist, and propranolol in the prophylaxis of migraine with or without aura. Following a 1 month single-blind placebo baseline period, 94 patients were equitably randomised under double-blind conditions to take flunarizine 10 mg daily or propranolol 80 mg twice daily for 4 months. Both treatments led to a significant reduction in the frequency of migraines and use of rescue analgesics with a significantly greater decrease in number of attacks for flunarizine after 1 and 4 months. Neither treatment affected the severity nor duration of migraines. Overall, 67% of flunarizine patients and 51 % of propranolol patients responded positively. Propranolol significantly reduced blood pressure and heart rate; flunarizine had no effect on cardiovascular function. Weight gain was noted with both treatments. Flunarizine is at least as effective as propranolol in the prophylactic treatment of migraine and may have a better safety profile.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 19 , Issue 3 , August 1992 , pp. 340 - 345
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

References

1.Edmeads, JG.Recent advances in pharmacotherapy: Migraine. Can Med Assoc J 1988; 138: 107–113.Google ScholarPubMed
2.Edmeads, JG.Advances in migraine prophylaxis: Introduction. In: Proceedings of a symposium at the XXVth meeting of the Canadian Congress of Neurological Sciences. Banff, Alberta: Canadian Congress of Neurological Sciences, June 1990.Google Scholar
3.Anonymous. Inderal® Product Monograph. In: Krogh, CME, Gillis, MC, Bisson, R, eds. Compendium of Pharmaceuticals and Specialties. 26th ed. Toronto: CK Productions, 1991: 575–577.Google Scholar
4.Solomon, GD.Comparative efficacy of calcium antagonist drugs in the prophylaxis of migraine. Headache 1985; 25: 368–371.CrossRefGoogle ScholarPubMed
5.Meyer, JS, Hardenberg, J.Clinical effectiveness of calcium entry in prophylactic treatment of migraine and cluster headaches. Headache 1983; 23: 266–277.CrossRefGoogle ScholarPubMed
6.Anonymous. Sibelium® Product Monograph. In: Krogh, CME, Gillis, MC, Bisson, R, eds. Compendium of Pharmaceuticals and Specialties. 26th ed. Toronto: CK Productions, 1991: 1106–1107.Google Scholar
7.Vanhoutte, PM, Paoletti, R.The WHO classification of calcium antagonists. Trends Pharmacol Sci 1987; 8.Google Scholar
8.Holmes, B, Brogden, RN, Heel, RC, et al. Flunarizine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use. Drugs 1984; 27(1): 6–44.CrossRefGoogle ScholarPubMed
9.Todd, PA, Benfield, P.Flunarizine: a reappraisal of its pharmacological properties and therapeutic use in neurological disorders. Drugs 1989; 38(4): 481–499.CrossRefGoogle ScholarPubMed
10.Sorensen, PS, Hansen, K, Olesen, J.A placebo-controlled, doubleblind, cross-over trial of flunarizine in common migraine. Cephalalgia 1986; 6: 7–14.CrossRefGoogle ScholarPubMed
11.Louis, P.A double-blind placebo-controlled prophylactic study of flunarizine (Sibelium®) in migraine. Headache 1981; 21: 235–239.CrossRefGoogle ScholarPubMed
12.Louis, P, Spierings, ELH.A comparison of flunarizine (Sibelium®) and pizotifen (Sandomigran®) in the treatment of migraine. A double-blind study. Cephalalgia 1982; 2: 197–203.CrossRefGoogle Scholar
13.Steardo, L, Marano, E, Barone, P, et al. Prophylaxis of migraine attacks with a calcium-channel blocker: flunarizine versus methysergide. J Clin Pharmacol 1986; 26: 524–528.CrossRefGoogle ScholarPubMed
14.Lucking, CH, Oestreich, W, Schmidt, R, et al. Flunarizine vs. propranolol in the prophylaxis of migraine: two double-blind comparative studies in more than 400 patients. Cephalalgia 1988; 8 (Suppl 8): 21–26.CrossRefGoogle ScholarPubMed
15.Ludin, HP.Flunarizine and propranolol in the treatment of migraine. Headache 1989; 29: 218–223.CrossRefGoogle ScholarPubMed
16.Shimell, CJ, Fritz, VU, Levien, SL.A comparative trial of flunarizine and propranolol in the prevention of migraine. S Afr Med J 1990; 77: 75–78.Google ScholarPubMed
17.Miles-McDermott, NJ, Fédérer, WT, Meredith, MP, Feng, ZD.The analysis of covariance for split unit and repeated measures experiments using the GLM procedure in SAS/STAT. Proceedings of the Thirteenth Annual SAS Users Group International (SUGI 13), SAS Institute Inc., Cary, North Carolina, 1988.Google Scholar
18.Health Services and Promotion Branch, Health and Welfare Canada. Promoting healthy weights: a discussion paper. Published by authority of the Minister of National Health and Welfare, Health and Welfare Canada. Ottawa: Minister of Supply and Services Canada, 1988.Google Scholar
19.Rosen, JA.Observations on the efficacy of propranolol for the proplyaxis of migraine. Ann Neurol 1983; 13: 92–93.CrossRefGoogle ScholarPubMed
20.Diamond, S, Kudrow, L, Steven, Jet al. Long-term study of propranolol in the treatment of migraine. Headache 1982; 22: 268–271.CrossRefGoogle ScholarPubMed
21.Hoffmann, BB, Lefkowitz, RJ.Adrenergic receptor antagonists: II. – adrenergic receptor antagonists. In: Goodman Gilman, A, Rail, TW, Nies, AS, Taylor, P, eds. Goodman and Gilman’s The pharmacological basis of therapeutics. 8th ed. Toronto: Pergamon Press, 1990: 229–241.Google Scholar
22.Olerud, B, Gustavsson, CL, Furberg, B.Nadolol and propranolol in migraine management. Headache 1986; 26: 490–493.CrossRefGoogle ScholarPubMed
23.Lugaresi, A, Montagna, P, Gallassi, Ret al. Extrapyramidal syndrome and depression induced by flunarizine. Eur Neurol 1988; 28: 208–211.CrossRefGoogle ScholarPubMed
24.Benvenuti, F, Baroni, A, Bandinelli, S, et al. Flunarizine – induced Parkinsonism in the elderly. J Clin Pharmacol 1988; 26: 600–608.CrossRefGoogle Scholar