Gracia-Naya M, Latorre-Jiménez A M
Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Rev Neurol. 2005;41(12):705-8.
Both flunarizine and, more recently, topiramate have proved to be effective in the prophylaxis of migraine.
To compare two independent groups of patients with similar clinical and demographic characteristics who were treated with flunarizine or topiramate as the preferred drug in the prevention of their migraines and to evaluate effectiveness and safety according to the medication they received.
All the patients reported more than four episodes a month and/or transformed migraine according to Silberstein's criteria, and had never received prophylactic treatment. Data determined: the number and average number of migraines in the previous month and at the fourth month of treatment, and the rate of respondents.
A total of 125 patients were included in each group. No significant differences were found between the groups as regards mean age or the average number of migraines in the previous month. With both drugs there was a significant decrease (0.0001) in the mean number of episodes in the fourth month of treatment, but with no significant difference between them: topiramate (5.88 +/- 3.7 to 2.1 +/- 2.5) and flunarizine (5.24 +/- 3.2 to 2.3 +/- 2.7). The mean reduction in the number of migraines at the fourth month was 58.2 +/- 38.2% with topiramate, and 55.4 +/- 37.5% with flunarizine. The respondent rate was 71% with topiramate and 67% with flunarizine. The percentage of dropouts with topiramate (28%) was higher than with flunarizine (11%) (0.0013). With topiramate 69 patients reported side effects and 53 patients reported them with flunarizine (0.0427).
Both drugs showed a high degree of effectiveness when used as the preferred drug in the preventive treatment of migraine. Topiramate offered better results as far as effectiveness is concerned, but also more side effects, none of which were serious.
氟桂利嗪以及最近的托吡酯已被证明在偏头痛预防方面有效。
比较两组具有相似临床和人口统计学特征的独立患者，他们分别接受氟桂利嗪或托吡酯作为预防偏头痛的首选药物治疗，并根据所接受的药物评估疗效和安全性。
所有患者每月发作次数超过4次和/或符合西尔伯斯坦标准的转化型偏头痛，且从未接受过预防性治疗。确定的数据包括：治疗前一个月和第四个月偏头痛的发作次数及平均发作次数，以及应答率。
每组共纳入125例患者。两组在平均年龄或前一个月偏头痛平均发作次数方面未发现显著差异。两种药物在治疗第四个月时发作平均次数均显著减少（P<0.0001），但两者之间无显著差异：托吡酯（从5.88±3.7次降至2.1±2.5次）和氟桂利嗪（从5.24±3.2次降至2.3±2.7次）。第四个月偏头痛发作次数的平均减少率，托吡酯为58.2±38.2%，氟桂利嗪为55.4±37.5%。托吡酯的应答率为71%，氟桂利嗪为67%。托吡酯的退出率（28%）高于氟桂利嗪（11%）（P=0.0013）。托吡酯有69例患者报告有副作用，氟桂利嗪有53例患者报告有副作用（P=0.0427）。
两种药物作为偏头痛预防性治疗的首选药物时均显示出高度有效性。就疗效而言，托吡酯效果更好，但副作用也更多，且均不严重。
