Schmidt R, Oestreich W
Medical Department, Janssen GmbH, Neuss, Germany.
J Cardiovasc Pharmacol. 1991;18 Suppl 8:S21-6.
Apart from the treatment of migraine attacks, prophylaxis may be required when certain criteria of frequency, duration, or severity are met. In a series of placebo-controlled, double-blind studies, the effectiveness of the cerebral calcium antagonist flunarizine (Sibelium) in migraine prophylaxis was shown. In further investigations, the effectiveness of flunarizine was similar to that of propranolol, metoprolol, pizotifene, and methysergide. The side effects described for treatment with flunarizine were somnolence, weight gain, and, in rare cases, depressive mood and extrapyramidal motor disorders. Considering the benefit/risk relation, flunarizine and the beta-adrenergic agents propranolol and metoprolol are now regarded as the drugs of choice. The mechanism of action of flunarizine in migraine prophylaxis is largely unexplained, but the antihypoxic effect of flunarizine is discussed in this context. The search for predicting factors for a successful treatment with flunarizine and the investigation of an injectable solution for the treatment of acute migraine attacks must be left to future research.
除了治疗偏头痛发作外，当满足某些频率、持续时间或严重程度标准时，可能需要进行预防。在一系列安慰剂对照的双盲研究中，已证明脑钙拮抗剂氟桂利嗪（西比灵）在偏头痛预防中的有效性。在进一步的研究中，氟桂利嗪的有效性与普萘洛尔、美托洛尔、苯噻啶和麦角新碱相似。氟桂利嗪治疗所描述的副作用有嗜睡、体重增加，在罕见情况下有抑郁情绪和锥体外系运动障碍。考虑到效益/风险关系，氟桂利嗪以及β-肾上腺素能药物普萘洛尔和美托洛尔现在被视为首选药物。氟桂利嗪在偏头痛预防中的作用机制在很大程度上尚不清楚，但在此背景下讨论了氟桂利嗪的抗缺氧作用。寻找氟桂利嗪成功治疗的预测因素以及研究用于治疗急性偏头痛发作的注射溶液必须留待未来研究。
