flunarizine and Headache

Novel disease-specific and mechanism-based treatments sharing good evidence of efficacy for migraine have been recently marketed. However, reimbursement by insurers depends on treatment failure with classic anti-migraine drugs. In this systematic review and meta-analysis, we aimed to identify and rate the evidence for efficacy of flunarizine, a repurposed, first- or second-line treatment for migraine prophylaxis.. A systematic search in MEDLINE, Cochrane CENTRAL, and ClinicalTrials.gov was performed for trials of pharmacological treatment in migraine prophylaxis, following the Preferred Reporting Items for Systematic Reviews (PRISMA). Eligible trials for meta-analysis were randomized, placebo-controlled studies comparing flunarizine with placebo. Outcomes of interest according to the Outcome Set for preventive intervention trials in chronic and episodic migraine (COSMIG) were the proportion of patients reaching a 50% or more reduction in monthly migraine days, the change in monthly migraine days (MMDs), and Adverse Events (AEs) leading to discontinuation.. Five trials were eligible for narrative description and three for data synthesis and analysis. No studies reported the predefined outcomes, but one study assessed the 50% reduction in monthly migraine attacks with flunarizine as compared to placebo showing a benefit from flunarizine with a low or probably low risk of bias. We found that flunarizine may increase the proportion of patients who discontinue due to adverse events compared to placebo (risk difference: 0.02; 95% CI -0.03 to 0.06).. Published flunarizine trials predate the recommended endpoints for evaluating migraine prophylaxis drugs, hence the lack of an adequate assessment for these endpoints. Further, modern-day, large-scale studies would be valuable in re-evaluating the efficacy of flunarizine for the treatment of migraines, offering additional insights into its potential benefits.

Topics: Flunarizine; Headache; Humans; Migraine Disorders; Migraine with Aura; Research Design; Transcription Factors

According to the principles of evidence-based medicine, the controlled studies on the treatment of idiopathic headache in childhood have been analysed and compiled to treatment recommendations. For the acute treatment of migraine attacks or tension-type headache, ibuprofen (10 mg per kg body weight) or acetaminophen (15 mg per kg body weight) are recommended with highest evidence, intranasal sumatriptan (10 to 20 mg) can be given as second choice. For the prophylaxis of migraine, betablockers (propranolol and metoprolol), flunarizine, and valproic acid are recommended. Flunarizine is the drug of first choice in the treatment of migraine-related disorders. No controlled studies are available for the treatment of further headache types. First line methods for the non-drug treatment of headache in childhood are relaxation therapies, biofeedback, and specific training schedules.

Topics: Acetaminophen; Adrenergic beta-Antagonists; Age Factors; Analgesics, Non-Narcotic; Biofeedback, Psychology; Child; Flunarizine; GABA Agents; Headache; Humans; Ibuprofen; Metoprolol; Migraine Disorders; Practice Guidelines as Topic; Propranolol; Relaxation Therapy; Serotonin Receptor Agonists; Sumatriptan; Tension-Type Headache; Valproic Acid; Vasodilator Agents

To investigate the impact of topiramate versus flunarizine on the non-headache symptoms (NHS) of migraine, and to observe the changes of dopamine (DA) and prolactin (PRL) before and after prophylactic treatment.. Sixty-six episodic migraine patients were enrolled and randomized 1:1 to receive either flunarizine or topiramate treatment. Clinical characteristics and NHS associated with migraine were investigated before and after prophylactic treatment. The DA and PRL levels were also determined before and after prophylactic treatment.. The NHS of migraine in the two groups were significantly better after treatment than before treatment in premonitory phase (PP), headache phase (HP), and resolution phase (RP). The NHS in the two groups had no significant difference in PP, HP, and RP before and after treatment. In the flunarizine group, the PRL content after treatment was significantly higher than that before treatment (. The two classical prophylactic drugs of migraine were significantly effective in treating the NHS of migraine, but there was no significant difference between the two drugs. The DA-PRL axis may be involved in the underlying mechanism of the flunarizine treatment for the NHS of migraine.

Topics: Dopamine; Flunarizine; Fructose; Headache; Humans; Migraine Disorders; Topiramate

To investigate the therapeutic effect and safety of acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine.. Multi-central, randomized and controlled trial was used and 253 cases of migraine were divided into an acupuncture group and a western medicine group. The acupuncture group was treated with acupuncture at points of The Liver and Gallbladder Channels with Taichong (LR 3), Yang-lingquan (GB 34), Fengchi (GB 20), Ququan (LR 8) selected as main points, and the western medicine group with oral administration of Flunarizine tablets for 4 therapeutic courses. The total therapeutic effects 3 and 6 months after the treatment, the scores of various symptoms of migraine before and after treatment, and the stability of therapeutic effect in one-year following-up survey were observed in the two groups.. After treatment, mean times and duration of the headache attack were significantly improved in the two groups (all P < 0.01) with the acupuncture group better than the western medicine group (P < 0.05). The total effective rates for stopping pain after treatment, 3 months and 6 months after treatment in the acupuncture group were 93.0%, 93.0% and 87.7%, respectively, which were better than 85.6%, 86.5% and 69.2% in the western medication group (all P < 0.01). One year later, the stability of the therapeutic effect in the acupuncture group was better than that in the western medicine group (P < 0.05); the adverse reaction and the compliance in the acupuncture group were significantly superior to those in the western medicine group.. Acupuncture at points of The Liver and Gallbladder Meridians for treatment of migraine is safe, effective, and with stable long-term therapeutic effect.

Topics: Acupuncture Points; Acupuncture Therapy; Administration, Oral; Adolescent; Adult; Aged; Female; Flunarizine; Gallbladder; Headache; Histamine H1 Antagonists; Humans; Liver; Male; Meridians; Middle Aged; Migraine Disorders; Treatment Outcome; Young Adult

Our purpose was to study the preventive effect of the calcium channel blocker flunarizine on headache, postural ataxia, and memory deficits occurring during decompression to high altitude in a randomized, placebo-controlled, double-blind study. After 7-day pretreatment with the study drugs, 20 healthy men were investigated at 490 m and 0.5, 2, 4, and 6 h later at a simulated altitude of 4559 m. Headache severity was evaluated on a 4-point scale. Sway path and anteroposterior and lateral sway were recorded with open and closed eyes by static posturography. Short- and long-term memory was studied by testing the recall of verbal and figural material immediately and 2 h after presentation, respectively. Blood pressure (BP) and arterial oxygen saturation (Sa(O2)) were also assessed. Headache scores showed a trend to be lower in the flunarizine group that was significant after 4 and 6 h. Headache scores expressed as difference from baseline values showed a nonsignificant trend to be lower at 4 and 6 h in subjects treated with flunarizine. Postural stance, memory, BP, and Sa(O2) were similar in both treatment groups. Although the low number of investigated subjects may have prevented the detection of a significant therapeutic effect of flunarizine, the present data do not show that flunarizine is effective for prevention of headache, postural ataxia, and neurocognitive deficits occurring at simulated high altitude.

Topics: Adult; Altitude Sickness; Ataxia; Blood Pressure; Decompression Sickness; Double-Blind Method; Flunarizine; Headache; Humans; Male; Memory Disorders; Oxygen Consumption; Prospective Studies; Treatment Outcome; Vasodilator Agents

Common childhood headaches seldom require prophylactic treatment which, nevertheless, is quite often unsatisfactory.. To study drug and non-drug related factors that may influence the therapeutic response.. A four-month follow-up study of all patients attended during a year at the neuropediatric, outpatient hospital-based clinic, with > or = 2 monthly migraine without aura attacks, > or = 10 tension-type headaches, or both types of headaches. Patients were randomized to be treated on an open basis, placebo controlled, with flunarizine or piracetam. Headache frequency was evaluated according to treatment and patients' basal characteristics.. 98 patients studied (56 migraine without aura, 24 tension-type headache, 18 mixed). 33% dropped out; they were school underachievers more frequently than those that completed the protocol. Of those completing the protocol and treated with placebo as the first choice of therapy, 27% reported total remission of symptomatology; those not remitting with placebo were high achievers at school significatively more frequently. At the end of the trial, 43% of the initially randomized patients still complained of headaches, regardless of treatment, showing a seasonal relationship.. Prophylaxis of benign childhood headaches is needed in less than half of those reporting a high headache frequency; school achievement should be taken into consideration as another clue to compliance and headache persistence. On a short-term basis only the seasonal influence and the placebo effect can be held responsible for amelioration of symptomatology.

Topics: Calcium Channel Blockers; Child; Female; Flunarizine; Headache; Humans; Male; Nootropic Agents; Piracetam; Prospective Studies; Treatment Outcome

Topics: Acute Disease; Administration, Sublingual; Adolescent; Adult; Aged; Clinical Trials as Topic; Ergotamine; Ergotamines; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders

Flunarizine was given in daily doses of 10 mg for periods of two to four months to 176 patients suffering from various types of headache. The symptoms were improved in 82% of the cases treated. No differences emerged among the various types of headache reported by the patients or in relation to the presence or absence of neurological involvement or its type.

Topics: Adolescent; Adult; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders; Piperazines; Vascular Headaches

Topics: Adolescent; Adult; Aged; Amitriptyline; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Vasodilator Agents

Flunarizine, a Ca-antagonist with demonstrated antimigraine properties, and indoprofen, an anti-inflammatory non-steroidal agent, were used in the treatment of daily chronic headache. Forty-two migraineurs with interval headache (MIH) were treated with flunarizine in a 6-month open trial, while indoprofen was administered to 23 patients with MIH and 7 with chronic tension headache (CTH) in a 2-month, double-blind, cross-over placebo-controlled study. Flunarizine was found effective in over 65% of the patients, while indoprofen was able to improve headache severity in only 30% of the subjects. In the responder patients, the effectiveness of both drugs is more pronounced in MIH, and seems to be ascribable to the ability of the treatments to reduce number and severity of attacks. A higher incidence of previous affective disturbances is found in non-responsive cases. The analysis of factors converting episodic into chronic headache shows slight but not significant differences between responders and non-responders. An impairment of plasma beta-endorphin levels, in the presence of normal ACTH, cortisol and nociceptive RIII threshold values, characterizes daily chronic headache (DCH) patients. Moreover, indoprofen does not significantly affect these biological and neurophysiological parameters independently of the therapeutic response.

Topics: Adult; Anti-Inflammatory Agents; Calcium Channel Blockers; Cinnarizine; Endorphins; Female; Flunarizine; Headache; Humans; Indoprofen; Male; Migraine Disorders; Pain; Phenylpropionates; Piperazines; Sensory Thresholds

Topics: Biomarkers; Brain-Derived Neurotrophic Factor; Calcitonin Gene-Related Peptide; Flunarizine; Headache; Humans; Migraine Disorders; Nerve Growth Factor; Serotonin

Migraine is the third most common disease in the world with an estimated prevalence of 14.7%. The purpose of this study was to identify the characteristic changes in cervical and ocular vestibular evoked myogenic potential (VEMP) and analyse changes in symptoms and VEMP after flunarizine therapy in patients diagnosed with vestibular migraine (VM).. Prospective interventional study was conducted on 31 VM patients. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were recorded. Flunarizine (10 mg) was given once daily for two consecutive months. Prophylactic therapy was monitored with a monthly follow-up assessment of their symptoms and VEMP was repeated after 2 months.. Headache was the chief complaint (67.7%). Vertigo was spontaneous and mostly moderate in intensity (93%). cVEMP was absent in 1 patient and oVEMP was absent in 3 patients. Post prophylactic treatment with flunarizine, there was significant reduction in the frequency (p = 0.001) and duration (p = 0.001) of headache and frequency (p = 0.001), duration (p = 0.001), and intensity (p = 0.009) of vertigo. cVEMP and oVEMP showed no significant differences (p > 0.05) between pre- and post-treatment recordings.. Treatment with flunarizine helps in considerably reducing the episodes and duration of headache, as well as episodes, duration, and intensity of vertigo.

Topics: Flunarizine; Headache; Humans; Migraine Disorders; Prospective Studies; Vertigo; Vestibular Evoked Myogenic Potentials

Preventive treatment is crucial for patients with chronic migraine (CM). This study explored the association between resting-state cortical oscillations and 3-month treatment outcome in patients with CM. Treatment-naïve patients with CM were recruited with their demographic data, psychosocial data, and headache profiles as well as the healthy controls (HCs). Resting-state cortical activities were recorded using an electroencephalogram and analysed using source-based and electrode-based spectral power method. The regions of interest were the bilateral primary somatosensory (S1) and visual (V1) cortices. After 3-month treatment with flunarizine, patients with CM were categorized into responders and nonresponders. Demographic, clinical, and electroencephalogram data from 72 patients with CM and 50 HCs were analysed. Elevated anxiety, depression, and stress were observed in patients with CM. Theta power in bilateral S1 and alpha and gamma powers in the right S1 increased in patients with CM. Nonresponders (n = 34) exhibited larger alpha powers in bilateral V1 than those in responders (n = 38). Alpha powers also exhibited significant correlations with changes of monthly headache days. Notably, in responders and nonresponders, occipital alpha powers did not differ at baseline and in the third month. In conclusion, patients with CM who were not responsive to preventive treatment were associated with augmented resting-state occipital alpha activity. Moreover, changes in migraine attack frequency were associated with baseline occipital alpha power. However, the prognostic feature of visual alpha oscillation seems to be inherent because it is not altered by flunarizine treatment. These findings may be useful for developing personalised migraine treatment plans.

Topics: Electroencephalography; Flunarizine; Headache; Humans; Migraine Disorders; Treatment Outcome

The prevalence of headache in childhood increases due to environmental factors. Various risk factors in children whose playgrounds are restricted outside and therefore remain inactive. So diagnosis and treatment can be challenging. The aim of this study was to evaluate the experience of flunarizine in childhood headache with a focus on efficacy and success. We conducted a retrospective observational study of 185 pediatric patients at the tertiary pediatric emergency and pediatric neurology unit between May 2018 and May 2020. Patients with headache for >15 days of a month for at least 3 months were included in the study, whether or not receiving treatment. Also, all patients who had an adequate follow-up period were included in the study. All patients were evaluated by history, physical-neurological examination, blood tests, blood pressure, eye examination, and cranial magnetic resonance imaging. All data were evaluated statistically. Ninety-eight (53%) of 185 cases were female and 87 (47%) were male. Average age was 11.4 years (min-max, 4-17). There was family history in 51.3% of the cases. The most frequent applicants were in the autumn season (43%), when schools were opened. Organic causes were hypertension in 1 case, brain tumor in 1 case, and papilledema due to idiopathic intracranial hypertension in 2 cases. The other cases were asked to make a 1-month pain chart and grading according to the visual analog scale. In this process, it was stated that painkillers could be used if needed. At the end of the first month, these patients were reevaluated. Flunarizine treatment was initiated in 95 patients who had to use painkillers for >4 times and who described ≥6 pain score according to the visual analog scale. The treatment was discontinued due to sleepiness and weakness in 2 patients. At the end of the third month, a 50% reduction in headache was observed in 82 cases (86.3%). We used flunarizine as the first choice in all patients and we achieved a high rate of treatment success. Flunarizine can be considered as an alternative option for headache management in terms of low side effects, easy accessibility, and compliance with treatment.

Topics: Analgesics; Child; Female; Flunarizine; Headache; Humans; Male; Retrospective Studies; Treatment Outcome

The Treatment Guideline Subcommittee of the Taiwan Headache Society evaluated the medications currently used for migraine prevention in Taiwan. The subcommittee assessed the results of recently published trials, meta-analyses, and guidelines. After expert panel discussions, the subcommittee reached a consensus on the preventive treatment of migraine in Taiwan, which includes recommendation levels, the strength of evidence, and essential prescription information (i.e., dosage and adverse effects) . The recent introduction of CGRP monoclonal antibodies has had a substantial effect on migraine treatment. Thus, the subcommittee updated the previous version of the treatment guideline published in 2017. Preventive medications for migraines can be divided into the following categories: ß-blockers, anticonvulsants, calcium channel blockers, antidepressants, onabotulinumtoxinA, anti-CGRP monoclonal antibodies, and complementary and alternative medicine. For episodic migraine prevention, propranolol, flunarizine, and topiramate are recommended as the first-line medications. Second-line medications for episodic migraine prevention include valproic acid, amitriptyline, and anti-CGRP monoclonal antibodies. Other treatment options could be used as third-line treatments. For chronic migraine prevention, topiramate, flunarizine, onabotulinumtoxinA, and anti-CGRP monoclonal antibodies are recommended as first-line therapies. Preventive medications for episodic migraine can also be used as second-line treatments for chronic migraine. For menstrual migraines, nonsteroidal anti-inflammatory drugs and triptans can be used for short-term prophylaxis. Indications for starting preventive treatment include a headache frequency of ≥4 days per month, profound disabilities, failure of or contraindication to acute therapies, a complicated migraine with debilitating (e.g., hemiplegic) auras, and migrainous brain infarction. The general principle for oral preventives is to "start low and go slow" while monitoring for adverse events and comorbid conditions. Physicians could consider gradually tapering the medications in patients with sustained improvement over 3 to 6 months in episodic migraine and 6 to 12 months in chronic migraine. Education about not overusing acute medications is also essential for all patients with migraine. Key words: migraine, preventive treatment, evidence-based medicine, guidelines, CGRP monoclonal antibodies, onabotulinumtoxinA, neuromodulation.

Topics: Antibodies, Monoclonal; Botulinum Toxins, Type A; Flunarizine; Headache; Humans; Migraine Disorders; Taiwan; Topiramate

Children with Sturge-Weber syndrome can experience severe headache with or without transient hemiparesis. Flunarizine, a calcium antagonist, has been used for migraine. The experience with flunarizine for headache in a cohort of children at a national center for Sturge-Weber syndrome is reviewed, reporting its efficacy and adverse effect in this population.. We collected data from health care professionals' documentation on headache (severity, frequency, duration) before and on flunarizine in 20 children with Sturge-Weber syndrome. Adverse effects reported during flunarizine treatment were collated. The Wilcoxon signed rank test was used to determine the significance of pre- versus post-treatment effect.. Flunarizine was used for headache alone (13) or mixed migrainous episodes and vascular events (7). The median duration of treatment was 145 days (range 43 to 1864 days). Flunarizine reduced headache severity (z = -3.354, P = 0.001), monthly frequency (z = -2.585, P = 0.01), and duration (z = -2.549, P = 0.01). Flunarizine was discontinued owing to intolerable adverse effects in a minority (2). Sedation and weight gain were the most common side effects. There were no reports of behavior change or extrapyramidal features.. The most effective management for headaches in patients with Sturge-Weber syndrome has not been established. This retrospective observational study found benefit of flunarizine prophylaxis on headache severity, frequency, and duration in children with Sturge-Weber syndrome without severe side effects. Flunarizine is not licensed for use in the United Kingdom, but these data support its off-license specialist use for headache prophylaxis in Sturge-Weber syndrome.

Topics: Adolescent; Calcium Channel Blockers; Child; Child, Preschool; Female; Flunarizine; Headache; Humans; Male; Paresis; Retrospective Studies; Sensation Disorders; Sturge-Weber Syndrome; Treatment Outcome

Topics: Adolescent; Adrenergic beta-Antagonists; Age Factors; Analgesics; Behavior Therapy; Child; Flunarizine; Headache; Health Behavior; Humans; Ibuprofen; Long-Term Care; Magnesium; Migraine Disorders; Sumatriptan

Hypnic headache is an infrequent type of primary headache characterised by appearing almost exclusively during sleep and by waking the patient up. The pain is dull (generally bilateral), is not associated to autonomic signs and usually appears from the age of 50 onwards.. A 10-year prospective study was conducted which describes the patients with hypnic headache who were attended in a specialised headache clinic. Data collected include demographic variables, the characteristics of the pain and response to treatment. Data from males and from females were compared.. Twenty-four patients were diagnosed with hypnic headache: 15 females and 9 males. There were no differences between sexes as regards the age at onset of the pain, the time elapsed until diagnosis, the number of episodes per month or the amount of time the pain lasted. The males reported a more intense pain (measured by means of the analogical visual scale) than the females. Neither were there any differences in terms of the presence of arterial hypertension or obstructive sleep apnoea syndrome. Response to different symptomatic and preventive treatments was scarce and with no differences between sexes.. The pain in hypnic headaches is more intense in males, although this needs to be corroborated in longer series. Further advances need to be made in the pathophysiology of this kind of headache so as to be able to find more efficient preventive pharmacological agents.

Topics: Age of Onset; Aged; Aged, 80 and over; Analgesics; Antidepressive Agents; Caffeine; Diagnosis, Differential; Female; Flunarizine; Headache; Headache Disorders, Primary; Humans; Male; Middle Aged; Pain Measurement; Polysomnography; Prospective Studies; Sex Distribution; Sleep Disorders, Intrinsic; Sleep, REM; Spain; Treatment Failure

Ehlers-Danlos syndrome is a rare inherited illness, which includes an autosomal dominant and also a recessive X-linked variant. Its main clinical characteristic is a generalised connective tissue involving collagen and elastin, causing fragile and hyperextensible skin, loose jointedness and bruising. Many clinical subtypes are described, each of a different severity degree pattern. The correlation of this syndrome and headache disorders is rare. In this paper we describe the case of a young woman with Type II (less severe) Ehlers-Danlos Syndrome and headache.

Topics: Adult; Brain; Calcium Channel Blockers; Ehlers-Danlos Syndrome; Female; Flunarizine; Headache; Humans; Magnetic Resonance Imaging; Migraine Disorders; Mouth; Radiography

The pathogenesis of hypnic headache is still unknown. Some authors supposed that the genesis of hypnic disorder is a decrease of melatonin secretion. It is a rare, moderately severe headache that occurs in middle-aged or elderly patients and affects both sexes. It appears exclusively during sleep and often with alarm clock regularity. The attack lasts from two to 6 hours, it may be unilateral or diffuse, pulsating or boring, without autonomic system features. Case 1. A 49 year old man reported the history of two week nocturnal headache that awakened him every night from sleep. The headache lasted two hours. There were no autonomic system features. Case 2. A 52 year old man suffered from nocturnal headaches for 6 weeks. The pain occurred between 2 and 5 almost every night and woke the patient. He suffered from diabetes mellitus too. Both patients were treated with flunarizine with good results.

Topics: Circadian Rhythm; Flunarizine; Headache; Humans; Male; Middle Aged; Severity of Illness Index

Three new cases compatible with hypnic headache syndrome (HHS) are presented. The patients were 70, 77, and 79 years of age (2F, 1M). They described a history of nocturnal headache ranging from 5 months to 7 years. One patient was afflicted with diffuse pain but the other two had unilateral pain. In one patient headache was clearly related with dreams, but in the other two this point could not be confirmed. Except for headache being unilateral in two cases, the remaining HHS criteria were present. It is noteworthy that pain responded to flunarizine in two patients.

Topics: Aged; Calcium Channel Blockers; Dominance, Cerebral; Dopamine Antagonists; Dreams; Female; Flunarizine; Headache; Humans; Male; Sleep Wake Disorders; Syndrome; Treatment Outcome

To analyse the results of out-patient treatment with diminishing doses of oral dihydroergotamine for patients with chronic migraine resulting from ergotics abuse.. A prospective and descriptive intervention study.. County hospital. Neurology out-patient clinic.. All the patients with chronic migraine as a side-effect of abuse of ergotic preparations who were referred to neurology out-patients over 18 months.. 1) Patients were told verbally of the causes of their migraine; 2) suppression of the ergotics, using diminishing doses of dihydroergotamine (Dihydergot gotas); 3) Prophylactic treatment with flunarizine (Sibelium); 4) Symptomatic treatment with sodic naproxen (Antalgin 550); 5) monthly and three-monthly check-up.. Over 18 months 25 patients with migraines due to ergotic abuse (6.7% of total migraines) were included. 4 were men; 21 women. Their average age was 43 (SD: 13). At one month the response was excellent in 19 patients (76%), good in 3 (12%) and bad in 3 (12%). At three months, the response was excellent in 17 patients (68%), good in 4 (16%), bad in 2 (8%) and 2 did not attend for the check-up (8%).. 1) Out-patient treatment with diminishing doses of oral dihydroergotamine is effective in treating chronic migraine due to ergotics abuse. 2) The general practitioner should intervene in the identification and prevention of ergotics abuse.

Topics: Administration, Oral; Adult; Aged; Ambulatory Care; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Dihydroergotamine; Ergot Alkaloids; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Naproxen; Prospective Studies; Substance-Related Disorders; Time Factors; Vasodilator Agents

Foot reflexology is defined as massage of zones on the feet which correspond to different parts of the body. A medline-search yielded no literature in the field of foot reflexology. Indications for and results of foot reflexology have been extrapolated from case-descriptions and two pilot studies with small samples. One study (Lafuente et al.) found foot reflexology to be as helpful to patients with headaches as medication (flunarizine), yet foot reflexology was fraught with less side-effects than medication. In a second study (Eichelberger et al.) foot reflexology was used postoperatively on gynecological patients. The intervention group showed a lesser need for medication to enhance bladder tonus than did the control group. The literature describes foot reflexology as enhancing urination, bowel movements and relaxation.

Topics: Female; Flunarizine; Foot; Genital Diseases, Female; Headache; Humans; Massage; Postoperative Complications; Urination Disorders

Migraine-like headaches may occasionally be seen in patients with scleroderma. The mechanism of these headaches is not well established but may be secondary to central "Raynaud's phenomenon". We report a patient with such headaches that responded dramatically to the centrally acting calcium channel blocker, flunarizine. We suggest that flunarizine should be considered in the management of patients with scleroderma and migraine-like headaches.

Topics: Female; Flunarizine; Headache; Humans; Middle Aged; Scleroderma, Systemic

The aim of our study was to evaluate the efficacy of long-term migraine prophylaxis with flunarizine. The efficacy of the drug was evaluated on the basis of the frequency, pain severity and duration of migraine attacks. Frequency, the most modified parameter, was reduced to about half of the pre-treatment level in one to three months time. The condition remained more or less stable from the third treatment month onwards. The results showed remarkable efficacy of long-term prophylaxis with flunarizine, and the response was better in younger patients with a short history of migraine.

Topics: Adult; Drug Evaluation; Female; Flunarizine; Headache; Humans; Longitudinal Studies; Male; Migraine Disorders

Topics: Dyskinesia, Drug-Induced; Female; Flunarizine; Headache; Humans; Middle Aged

Topics: Female; Flunarizine; Headache; Humans; Tremor

Topics: Adolescent; Adult; Flunarizine; Headache; Humans; Middle Aged; Spinal Puncture

Topics: Adolescent; Adult; Body Weight; Drug Administration Schedule; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders; Sex Factors

Topics: Adolescent; Adult; Drug Administration Schedule; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders; Muscle Contraction

Changes in erythrocyte deformability (ED) parameters have been investigated in 36 patients suffering from different forms of headache (classic and common migraine; migraine with interval headache; chronic tension headache) and treated with flunarizine (10 mg/day at bedtime). Patients were carefully selected in order to avoid any possible interference with the parameters under study, and smoke and drug use in particular (symptomatics included) were considered as criteria for exclusion from the trial. Controls of ED parameters were planned before treatment and after 20 and 35 days. Baseline ED alterations were present only among patients with chronic tension headache, but flunarizine treatment was able to positively modify ED parameters in these patients, as well as in migraine cases that showed normal baseline ED values. No correlation was found between patients' characteristics and baseline ED values, nor between ED changes under treatment and therapeutic effects of flunarizine.

Topics: Adult; Calcium Channel Blockers; Cinnarizine; Erythrocyte Deformability; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders; Piperazines

Fifty-two patients, most of whom had had daily headaches for years, were examined and treated. Among them there were 40 who originally had migraine, the others had vasomotor or post-contusional headaches. Average duration of the migraine was 21 years, of chronic headache 7.6 years. All patients had been taking analgesics of a mixed type regularly and for a long time, on average 35.6 tablets or suppositories weekly. All patients had taken more than three different drugs. After an observation period of 3-6 months for grading the headaches and registering the amount of drug intake, all patients were admitted to hospital when all analgesics were at once discontinued. Changing degrees of withdrawal symptoms were the rule: increased headaches, nausea, vomiting, tachycardia, sweating, sleep disorders, and in some also hallucinations and cerebral episodes. At the end of the hospital stay chronic headache had completely disappeared or markedly improved in 77% of patients. Even after an average of 16 months of subsequent observation, chronic headache continued to be significantly improved in 70% of patients. There was a significant reduction in frequency and intensity of attacks in the patients with originally typical migraine. Regular intake of analgesics of the mixed type induces chronic headaches. These are most commonly caused by ergotamine tartrate and aminophenol derivatives, while psychological and physical dependence on anti-migraine drugs is initiated and maintained by additional barbiturates, caffeine and codeine.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Analgesics; Chronic Disease; Cinnarizine; Female; Flunarizine; Headache; Humans; Male; Middle Aged; Migraine Disorders; Pizotyline; Substance Withdrawal Syndrome