Ghiami Hamed, Parsapour Mohammadsalman, Khalilzadeh Sahba, Rahmani Hanieh, Omidkhoda Navid, Arasteh Omid
Department of Pharmacy, Damghan Branch, Islamic Azad University, Damghan, Iran.
Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2025 Jun 28. doi: 10.1007/s00210-025-04422-2.
Numerous innovative treatment approaches have been developed to treat migraine, one of the most upsetting disorders. However, the optimal strategy for managing migraines remains unclear. The calcium channel blockers have demonstrated some positive effects on migraine attacks. In this systematic review, we tried to gather data on the efficacy and safety of these drugs to reach a more precise conclusion.
The databases of PubMed, Scopus and Web of Science were searched systematically up to 1 August 2024. The risk of bias was assessed for clinical trials through the Cochrane Collaboration's tool.
Out of 1903 studies, we included 40 clinical trials. Among 27 studies on flunarizine (FLU), most of them showed significantly superior effects in comparison with placebo or other agents. Sedation and weight gain were the most prevalent side effects experienced by FLU. Although three studies demonstrated positive effects of nimodipine (NIM) in migraine management, the seven remaining studies revealed controversial results. Three and one articles evaluating the efficacy and safety of nifedipine (NIF) and verapamil (VER) to other drugs, respectively, reported no special effects.
According to reviewed research, FLU appears to have the greatest impact on migraine episodes, whereas NIM outperforms B blockers in terms of migraine prevention. Further study is necessary to get more precise data on NIF and VER.
已经开发出许多创新的治疗方法来治疗偏头痛，这是最令人苦恼的疾病之一。然而，偏头痛的最佳管理策略仍不明确。钙通道阻滞剂已被证明对偏头痛发作有一些积极作用。在这项系统评价中，我们试图收集这些药物的疗效和安全性数据，以得出更精确的结论。
系统检索了截至2024年8月1日的PubMed、Scopus和Web of Science数据库。通过Cochrane协作工具评估临床试验的偏倚风险。
在1903项研究中，我们纳入了40项临床试验。在27项关于氟桂利嗪（FLU）的研究中，大多数研究表明与安慰剂或其他药物相比，其效果显著更好。镇静和体重增加是氟桂利嗪最常见的副作用。尽管三项研究证明尼莫地平（NIM）在偏头痛管理中有积极作用，但其余七项研究结果存在争议。分别有三篇和一篇文章评估硝苯地平（NIF）和维拉帕米（VER）与其他药物相比的疗效和安全性，均未报告有特殊效果。
根据综述研究，氟桂利嗪似乎对偏头痛发作影响最大，而尼莫地平在预防偏头痛方面优于β受体阻滞剂。有必要进一步研究以获取关于硝苯地平和维拉帕米更精确的数据。
