Flunarizine in Migraine: A Double‐blind Placebo‐controlled Study (in a Saudi Population)

Deeb, Stephanie; Bahou, Yacoub; Jaberi, Mina; Khoja, Waleed

doi:10.1111/j.1526-4610.1992.hed3209461.x

Cited by 13 publications

(5 citation statements)

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“…The AHCPR Technical Report identified 45 controlled trials of calcium antagonists, including flunarizine (25 trials), nimodipine (11 trials), nifedipine (five trials), verapamil (three trials), cyclandelate (three trials), and nicardipine (one trial) (10). Flunarizine was compared with placebo in eight migraine prevention trials and effect sizes could be calculated for seven studies (107–113) but not the eighth study (114). A meta‐analysis of these seven heterogeneous trials was statistically significant in favour of flunarizine.…”

Section: Clinical Trialsmentioning

confidence: 99%

Migraine: Preventive Treatment

Silberstein¹,

2002

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Migraine is a common episodic headache disorder. A comprehensive headache treatment plan includes acute attack treatment to relieve pain and impairment and long-term preventive therapy to reduce attack frequency, severity, and duration. Circumstances that might warrant preventive treatment include: (i) migraine that significantly interferes with the patient's daily routine despite acute treatment; (ii) failure, contraindication to, or troublesome side-effects from acute medications; (iii) overuse of acute medications; (iv) special circumstances, such as hemiplegic migraine; (v) very frequent headaches (more than two a week); or (vi) patient preference. Start the drug at a low dose. Give each treatment an adequate trial. Avoid interfering, overused, and contraindicated drugs. Re-evaluate therapy. Be sure that a woman of childbearing potential is aware of any potential risks. Involve patients in their care to maximize compliance. Consider co-morbidity. Choose a drug based on its proven efficacy, the patient's preferences and headache profile, the drug's side-effects, and the presence or absence of coexisting or co-morbid disease. Drugs that have documented high efficacy and mild to moderate adverse events (AEs) include beta-blockers, amitriptyline, and divalproex. Drugs that have lower documented efficacy and mild to moderate AEs include selective serotonin reuptake inhibitors (SSRIs), calcium channel antagonists, gabapentin, topiramate, riboflavin, and non-steroidal anti-inflammatory drugs.

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Section: Clinical Trialsmentioning

confidence: 99%

Migraine: Preventive Treatment

Silberstein¹,

2002

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“…Although there are 7 double-blind, randomized, placebocontrolled studies in which flunarizine, in a single nocturnal dose of 10 mg, was shown to reduce the frequency, the duration, and the intensity of migraine attacks, these studies do not present the necessary requirements to categorize this finding as Level A evidence due to various factors, especially the low number of subjects studied. 32,[52][53][54][55][56][57] Three meta-analysis studies corroborate the positive results from primary outcomes, [58][59][60] with the caveat in one of them 60 that the decrease in the frequency of headache attacks would take place at weeks 8, 12, 16, and 20, but not in week 4.…”

Section: Studiesmentioning

confidence: 69%

“…Although there are 7 double-blind, randomized, placebo-controlled studies in which flunarizine, in a single nocturnal dose of 10 mg, was shown to reduce the frequency, the duration, and the intensity of migraine attacks, these studies do not present the necessary requirements to categorize this finding as Level A evidence due to various factors, especially the low number of subjects studied. 32 52 53 54 55 56 57…”

Section: Calcium Channel Blockersmentioning

confidence: 99%

Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II

et al. 2022

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Background Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. Objective The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. Methods Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. Results From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. Conclusions Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.

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“…Most of the outcome measures used in our trial were based on patient’s subjective feelings and there weren’t many objective indicators. Besides, a daily dose of 5 mg flunarizine was a relatively low dose compared with the previous studies [ 38 , 39 ] which may have led to a modest improvement in the efficacy outcome measures of migraine. Ten milligram flunarizine may guarantee a more rapid efficacy [ 40 ].…”

Section: Discussionmentioning

confidence: 83%

Zhengtian Capsule versus flunarizine in patients with migraine: a multi-center, double-blind, double-dummy, randomized controlled, non-inferior clinical trial

Cao

Han

Lin

et al. 2016

BMC Complement Altern Med

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BackgroundThe primary objective of this study was to assess whether Zhengtian Capsule was non-inferior to flunarizine in efficacy and safety profile for prevention of migraine in adults.MethodsThis was a double-dummy, double-blind, multicenter, positive drug (flunarizine), parallel randomized controlled, non-inferior clinical trial. Patients (n = 360) were randomized in a 1:1 to receive either Zhengtian Capsule or flunarizine, including 12 weeks’ intervention and 4 weeks’ follow-up. The primary outcome measure was responder rate (defined as the percentage of subjects in a treatment group with 50 % or greater reduction in attack frequency during treatment compared with the baseline period). The secondary outcome measures included migraine attack frequency, the number of migraine days, pain evaluated by visual analogue scale (VAS) score, duration of migraine attacks, the times of using analgesics, patient-reported outcome (PRO) measure of migraine and the scores of short-form 36 Health Survey Scale (SF-36). Weight variation in both groups was also evaluated. Adverse events were monitored throughout the trial.ResultsZhengtian Capsule was non-inferior to flunarizine in responder rate at week 12 and follow-up period (P = 0.002, P < 0.001). There was fewer migraine days in Zhengtian Capsule group at follow-up period compared with flunarizine (P = 0.001). For the total duration of migraine attacks, there was significant group difference at week 4 which favored the control group (P = 0.009). For the total score of PRO scale, there was statistical difference between the two groups at follow-up period (P = 0.021). There were also group differences between the two groups in the dimensions of somatization symptoms at week 4 (P = 0.022) and functional status at week 12 and follow-up period (P < 0.001, P < 0.001). However, there were no significant differences between the two groups in migraine attack frequency, VAS scores reduction, consumption of acute pain drugs and the dimension scores of SF-36 at any time interval of the treatment period (P > 0.05). No severe adverse events occurred in the trial. Flunarizine was found associated with a weight gain.ConclusionZhengtian Capsule was non-inferior to flunarizine with regard to the primary endpoint. In addition, it could reduce migraine days and improve the functional status and somatization symptoms of migraine patients with good safety profile.Trial registrationThis trial was registered at Chinese Clinical Trial Register (ChiCTR), ChiCTR-TRC-13004412.

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Flunarizine in Migraine: A Double‐blind Placebo‐controlled Study (in a Saudi Population)

Cited by 13 publications

References 0 publications

Migraine: Preventive Treatment

Migraine: Preventive Treatment

Consensus of the Brazilian Headache Society (SBCe) for prophylactic treatment of episodic migraine: part II

Zhengtian Capsule versus flunarizine in patients with migraine: a multi-center, double-blind, double-dummy, randomized controlled, non-inferior clinical trial

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