COMPARISON OF THE EFFICACY BETWEEN FLUNARIZINE AND NIFEDIPINE IN THE PROPHYLAXIS OF MIGRAINE

Background. Several calcium channel blockers have been evaluated in controlled clinical studies and some hold considerable promise for future. Efficacy in migraine prophylaxis has been claimed for drugs belonging to all three classes of calcium channel blockers (nifedipine-like, verapamil-like, and flunarizine-like), but the extent and quality of the evidence varies, and a comparison of efficacy between different calcium channel blockers has not been reported. Objective. The objective of the study is to assess the comparison of efficacy and safety of flunarizine and nifedipine in migraine prophylaxis. Patients and methods. The study was conducted in a prospective, double-blind, randomized controlled trial, parallel group design. 78 patients were studied for a 1-month period during which all patients received placebo followed by a 3-month experimental period. Headache response to medication was measured monthly by compilation of migraine-scores derived from quantitative data recorded by patients in a daily diary.1 Student's t-test was used to compare results from the flunarizine (10 mg) and nifedipine (20 mg) group for each month. Results. Both groups showed a significant reduction in the migraine-scores after 3-months. No significant differences were detected between groups, but there was a clinical significantly different reduction of migraine-scores between the groups in the first month after the run-in period (58% vs 38%). It shows that the beneficial effect of flunarizine was more rapidly manifest than that of flunarizine. Tachycardia more frequently occurred in the nifedipine group than in the flunarizine treatment group. Conclusion. It concluded that flunarizine is a potentially more useful agent in the prophylaxis of migraine headache.