Skip to main content
Log in

A postmarketing study of flunarizine in migraine and vertigo

  • Published:
Pharmacy World and Science Aims and scope Submit manuscript

Abstract

This prospective, open multi-centre study on flunarizine focused on the risk/benefit ratio of the use of flunarizine in the prophylaxis of migraine and in the treatment of vertigo, due to disorder of the vestibular system. The assessment of risks focused on the incidence of new events of depression and/or extrapyramidal syndrome during flunarizine treatment. For migraine, flunarizine was compared to propranolol in 686 patients; for vertigo, flunarizine was compared to betahistine in 198 patients. The incidence of depression during follow-up in this study was significantly higher in the flunarizine group than in the propranolol group in the condition of migraine. There were no observations of an extrapyramidal syndrome. There was a suggestion that flunarizine has more benefits than propranolol in the condition of migraine, and that betahistine has more benefit than flunarizine in the condition of vertigo. Differences in dosages could possibly explain these differences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Holmes B, Brogden RN, Heel RC, Speight TM, Avery GS. Flunarizine: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use. Drugs 1984;27:6–44.

    Google Scholar 

  2. Verhaeghe R, Verstraete M. Drugs acting on the cerebral and peripheral circulations. In: Dukes MNG, ed. Meyler's side-effects of drugs. Elseviers Science Publishers BV, 1992.

  3. Micheli FE, Pardal MM, Giannaula R et al. Movement disorders and depression due to flunarizien and cinnarizine. Mov Disord 1989;4:139–46.

    Google Scholar 

  4. Benvenuti F, Baroni A, Bandinelli S, Ferrucci L, Corradetti R, Pantaleo T. Flunarizien-induced parkinsonism in the elderly. J Clin Pharmacol 1988;28:600–8.

    Google Scholar 

  5. Lugaresi A, Montagna P, Gallassi R, Lugaresi E. Extrapyramidal syndrome and depression induced by flunarizine. Eur Neurol 1988;28:208–11.

    Google Scholar 

  6. Moretti A, Lucantoni C. Flunarizine-induced parkinsonism: clinical report. Ital J Neurol Sci 1988;9:295–7.

    Google Scholar 

  7. Di Rosa AE, Morgante L, Meduri M et al. Parkinson-like side effects during prolonged treatment with flunarizine. Funct Neurol 1987;2:47–50.

    Google Scholar 

  8. Micheli F, Pardal MF, Gatto M et al. Flunarizine-and cinnarizine-induced extrapyramidal reactions. Neurology 1987;37:881–4.

    Google Scholar 

  9. Chouza C, Scaramelli A, Caamano JL, De Medina O, Aljanati R, Romero S. Parkinsonism, tardive dyskinesia, akathisia and depression induced by flunarizine. Lancet 1986;ii:1303–4.

    Google Scholar 

  10. Cappella D, Laporte JR, Castel JM, Tristan C, Cos A, Morales-Olivas FJ. Parkinsonism, tremor and depression induced by cinnarizine and flunarizine, Brit Med J 1988;297:722–3.

    Google Scholar 

  11. Assmann VCCA, Perquin WVM, Touw DJ. Extrapiramidal dyskinesia due to flunarizine. Ned Tijdschr Geneesk 1988;132:1940–2.

    Google Scholar 

  12. Petri H, De Vet HCW, Naus J, Urquhart J. Prescription sequence analysis: a new and fast method for assessing certain adverse reactions of prescription drugs in large populations. Stat Med 1988;7:1171–5.

    Google Scholar 

  13. Petri H, Leufkens H, Naus J, Silkens R, Van Hessen P, Urquhart J. Rapid method for estimating the risk of acutely controversial side effects of prescription drugs. J Clin Epidemiol 1990;43:433–9.

    Google Scholar 

  14. Germans restrict flunarizine use. SCRIP 1991;1599:23.

  15. CPMP restricts flunarizine indications. SCRIP 1991;1601:22.

  16. Verspeelt J, De Locht P, Amery WK. Post-marketing study of the use of flunarizine in vestibular vertigo and in migraine. Accepted for publication in Eur J Clin Pharm.

  17. International classification of diseases. Manual of the international statistical classification of diseases, injuries, and causes of death. Based on the recommendations of the Ninth Revision Conference, 1975, and adopted by the Twenty-ninth World Health Assembly. Geneva, World Health Organization. 1977 (Volumes 1 and 2).

    Google Scholar 

  18. Armitage P, Berry G. Statistical methods in medical research. Oxford: Blackwell Scientific Publications, 1987 (second edition).

    Google Scholar 

  19. Thiessen BQ, Wallace SM, Blackburn JL, Wilson TW, Bergman U. Increased prescribing of antidepressants subsequent to beta-blocker therapy. Arch Intern Med 1990;150:2286–90.

    Google Scholar 

  20. Griffin SJ, Friedman MJ. Depressive symptoms in propranolol users. J Clin Psychiatry 1986;47:543–7.

    Google Scholar 

  21. Cremona-Barbaro A. Propranolol and depression [letter]. Lancet 1983;i:185.

    Google Scholar 

  22. Van Marwijk HWJ, Grundmeijer HGLM, Brueren MM et al. NHG-standaard depressie. Huisarts Wet 1994.

  23. Breslau N, Davis GC, Schultz LR, Peterson EL. Migraine and major depression: a longitudinal study. Headache 1994;34:387–93.

    Google Scholar 

  24. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Arch Gen Psychiatry 1990;47:849–53.

    Google Scholar 

  25. Negrotti A, Calzetti S, Sasso E. Calcium-entry blockers-induced parkinsonism: possible role of inherited suspectibility. Neurotoxicology 1992;13:261–4.

    Google Scholar 

  26. Laporte JR, Capella D. Useless drugs are not placebos: lessons from flunarizine and cinnarizine. Lancet 1986;853–4.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Bock, G., Eelhart, J., van Marwijk, H. et al. A postmarketing study of flunarizine in migraine and vertigo. Pharm World Sci 19, 269–274 (1997). https://doi.org/10.1023/A:1008617825269

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008617825269

Navigation