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Flunarizine in migraine‐related headache prevention: results from 200 patients treated in the UK
Author(s) -
Karsan N.,
Palethorpe D.,
Rattanawong W.,
Marin J. C.,
Bhola R.,
Goadsby P. J.
Publication year - 2018
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13621
Subject(s) - flunarizine , medicine , migraine , topiramate , adverse effect , aura , migraine treatment , discontinuation , migraine with aura , pediatrics , anesthesia , psychiatry , epilepsy , calcium
Background and purpose For over 20 years, as a group we have been using flunarizine in primary headache disorders. Flunarizine is widely used in Europe, but not licensed in the UK . In September 2014, the National Institute for Clinical Excellence published supportive guidelines for flunarizine use in migraine, based on randomized controlled evidence that it is as effective as propranolol and topiramate in adults. Methods We reviewed a cohort of adult patients ( n = 200) treated with flunarizine from our practice. The clinical information of these patients, i.e. diagnosis, dose, efficacy, side effects and duration of treatment, was collected. Results The most common indication for flunarizine use was chronic migraine, followed by migraine with aura, sporadic hemiplegic migraine, familial hemiplegic migraine and new daily persistent headache with migrainous features. Flunarizine was generally effective, with only 24% ( n = 47) of patients reporting no clinical effect. The most common dose used was 10 mg per day. Duration of treatment information was available for 39% ( n = 78) of patients. Of these patients, 64% ( n = 50) continued treatment for more than 1 year. Doses up to 15 mg were generally well tolerated, with only 10.5% ( n = 21) of patients stopping treatment due to adverse effects. The most common adverse events were tiredness, mood change and weight gain. Conclusion The data provide supportive evidence from tertiary headache practice in the UK for the use of flunarizine in migraine. The data encourages development of future guidance regarding flunarizine use in headache centres in countries where its use is not routine.