Wessely P, Holzner F
Wien Med Wochenschr. 1987 Jan 15;137(1):21-6.
A short episode of focal cortical hypoxia seems to be the turning-point in the genesis of the migraine attack. This pathophysiological situation induces vascular changes according to the hypothesis of Wolff. Under such conditions some Ca-antagonists develop antihypoxic and antivasoconstrictive properties. The efficiency of Flunarizine as potent prophylactic drug in migraine therapy is well documented in many double-blind randomized studies versus placebo or other antimigrainous drugs. Based on the positive results of these studies, we liked to investigate the efficiency and tolerability of Flunarizine also in a sample on n = 44 adults Austrian patients recruited from the Headache-Ambulance of the Neurological Department, University of Vienna. After a 3 months treatment with Flunarizine, 10 mg daily, there was a drug free follow-up period of 4 to 12 months. After this time in 29 patients (66.6%) there was a decrease of attack frequency of more than 50%. 12 (27.3%) of them were completed free of attacks. Beside this, the intake of attack ameliorating drugs (ergotamine, analgetics) was markedly reduced. Treatment was well tolerated. Weight gain was observed in 20.3% of patients likely correlating with the therapeutic efficiency. Due to its efficiency, safety and its long-lasting therapeutic effect, Flunarizine appears to be a very suitable agent in the prophylaxis of migraine.
短暂的局灶性皮质缺氧似乎是偏头痛发作起源的转折点。根据沃尔夫的假说,这种病理生理状况会引发血管变化。在这种情况下,一些钙拮抗剂会产生抗缺氧和抗血管收缩的特性。在许多与安慰剂或其他抗偏头痛药物对比的双盲随机研究中,氟桂利嗪作为偏头痛治疗有效预防药物的效果已有充分记录。基于这些研究的阳性结果,我们也希望在从维也纳大学神经科头痛急救中心招募的44名奥地利成年患者样本中研究氟桂利嗪的疗效和耐受性。在用氟桂利嗪每日10毫克治疗3个月后,有4至12个月的停药随访期。在此之后,29名患者(66.6%)的发作频率降低了50%以上。其中12名患者(27.3%)完全没有发作。除此之外,缓解发作药物(麦角胺、镇痛药)的摄入量明显减少。治疗耐受性良好。20.3%的患者出现体重增加,这可能与治疗效果相关。由于其疗效、安全性和持久的治疗效果,氟桂利嗪似乎是预防偏头痛的非常合适的药物。