INTRODUCTION.
Flunarizine, with level of evidence A, and
nadolol, with evidence level C, would be indicated as preventive treatment of
migraine. Yet, no previous studies have been conducted to compare the effectiveness of the two drugs. AIM. To compare the effectiveness parameters in independent groups of patients treated preventively with one of the
pharmaceuticals from the study, the same protocol being applied in both cases. PATIENTS AND METHODS. The subjects selected for the study were patients with episodic
migraine (according to 2004 International
Headache Society criteria) who had undergone preventive treatment for the first time, with
flunarizine (5 mg/day) or
nadolol (20-40 mg/day). The main effectiveness variables (reduction in the number of
seizures at four months of treatment and responder rates) were analysed. RESULTS. The study included 227 patients who intended to receive treatment: 155 with
flunarizine (80.5% females; mean age: 38.3 ± 12.1 years) and 72 with
nadolol (63.8% females; mean age: 37.1 ± 12.0 years). The mean number of
seizures prior to treatment was 6.09 ± 2.6 in the
flunarizine group and 5.1 ± 1.7 in the
nadolol group (p = 0.0079); at four months of treatment it was 2.61 ± 2.4 in the
flunarizine group and 2.77 ± 2.4 in the
nadolol group (p = NS). Percentage of reduction of
migraines: 55.2% with
flunarizine and 50.4% with
nadolol (p = NS). The responder rate was 69% with
flunarizine and 67% with
nadolol (p = NS). The excellent response rate (reduction in the number of
seizures by 75% or more) was 52.2% with
flunarizine and 36.1% with
nadolol (p = 0.0077). Percentage of adverse side effects: 48.3% with
flunarizine and 25% with
nadolol (p = 0.0009). The satisfaction rate was similar in both groups, 68%. CONCLUSIONS. Both
flunarizine and
nadolol proved to be effective in the preventive treatment of episodic
migraine.
Flunarizine is used more often in our milieu and was less well tolerated.