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Flunarizine versus topiramate for chronic migraine prophylaxis: a randomized trial
Author(s) -
Lai K.L.,
Niddam D. M.,
Fuh J.L.,
Chen S.P.,
Wang Y.F.,
Chen W.T.,
Wu J.C.,
Wang S.J.
Publication year - 2017
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12626
Subject(s) - flunarizine , topiramate , migraine , medicine , randomized controlled trial , anesthesia , epilepsy , psychiatry , calcium
Objectives Chronic migraine ( CM ) is a prevalent and devastating disorder with limited therapeutic options. This study explored the efficacy of 10 mg/d flunarizine for CM prophylaxis as compared with 50 mg/d topiramate. Methods We conducted a prospective, randomized, open‐label, blinded‐endpoint trial. Patients with CM were randomized to flunarizine and topiramate treatment. The primary outcomes assessed were the reductions in the total numbers of headache days and migraine days after 8 weeks of treatment. Secondary outcomes were reductions in the numbers of days of acute abortive medication intake and acute abortive medication tablets taken, and the 50% responder rate. Results Sixty‐two subjects were randomized (n=31/group). Patients treated with flunarizine showed significant reductions in the numbers of total headache days (−4.9 vs −2.3, P =.012) and migraine days (−4.3 vs −1.4, P =.001) compared with those treated with topiramate. Patients treated with flunarizine also showed significant reductions in the numbers of days of acute abortive medication intake (−2.3 vs −0.2, P =.005) and acute abortive medication tablets taken (−4.6 vs −0.5, P =.005) and had a higher 50% responder rate in terms of total headache days (58.6% vs 25.9%, P =.013) and migraine days (75.9% vs 29.6%, P =.001), compared with topiramate‐treated patients. Flunarizine was generally well tolerated and had a safety profile comparable to that of topiramate. Conclusions Our results suggest that, in an 8‐week study, 10 mg/d flunarizine is more effective than 50 mg/d topiramate for CM prophylaxis.