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Flunarizine versus topiramate in migraine prophylaxis and their effect on psychomotor ability: A prospective open-label study

Alok Dixit, Devesh Pandey, Nasreen Fatma Khan, Chandraveer Singh, Asha Pathak, Ramakant Yadav.




Abstract

Background: About 9% of the overall population suffers from migraine headaches, with a female majority. For the prevention of migraines, the two most often prescribed drugs are topiramate (TPM) and flunarizine. Regarding TPM and flunarizine’s long-term efficacy, safety, and adverse effects on migraine prevention, little is known. To evaluate the effectiveness of flunarizine against TPM in migraine prophylaxis and its impact on psychomotor ability, the current study was designed.

Aims and Objectives: The aim of the study was to compare the efficacy of flunarizine and TPM in the prophylaxis of migraine and to assess change in the psychomotor ability of the brain using different psychomotor analysis scoring systems.

Materials and Methods: A comparative, open-label, and prospective study was carried out on patients with chronic migraine from the outpatient department of the neurology department at Uttar Pradesh University of Medical Sciences, Saifai, Uttar Pradesh, with flunarizine and TPM treatment (n = 20/group) for 2 months. Data regarding patient’s scores of headache severity on the Visual Analogue Scale (VAS), digit later substitution test, 6 letter cancellation test, digit span test, mathematical ability test, and flicker fusion apparatus test were recorded and analyzed.

Results: When compared to the baseline, the mean±standard deviation pain severity score on the VAS was 2.9 ± 0.8 in the flunarizine group and 3.7 ± 1.4 in the TPM group, with a P < 0.001. Furthermore, the flunarizine group showed less decline in performances in the scores of each psychomotor test as compared with the scores of the TPM treatment group when baseline values were compared at 1 and 2 months.

Conclusion: Flunarizine is well tolerated, has a better safety profile, and has less cognitive decline as compared to TPM.

Key words: Chronic Migraine; Visual Analogue Scale; Flicker Fusion Apparatus Test






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