Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial.

Abstract

Migrainous vertigo is a common cause of dizziness presenting to an otorhinolaryngology/otoneurology clinic. Although it causes a substantial burden to the individual and society there are no randomized controlled trails on prophylactic medication for this condition. Flunarizine, a calcium channel blocker has been used effectively in both migraine and vestibular conditions. This randomized control trial was undertaken in a tertiary academic referral center to evaluate the efficacy of flunarizine in patients with migrainous vertigo when compared to non-specific vestibular treatment of betahistine and vestibular exercises. The effect of flunarizine on two particularly disabling symptoms of vertigo and headache was studied. A total of 48 patients who were diagnosed with definitive migrainous vertigo completed the study of 12 weeks duration. Patients in arm A received 10-mg flunarizine daily along with betahistine 16 mg and paracetamol 1 gm during episodes, and arm B received only betahistine and paracetamol during episodes. Symptom scores were noted at the start of the study and at the end of 12 weeks. Analysis of the frequency of vertiginous episodes showed a significant difference between arm A and arm B (p = 0.010) and improvement in severity of vertigo between the two groups (p = 0.046). Headache frequency and severity did not improve to a significant degree in arm A as compared to arm B. The main side effects were weight gain and somnolence and this was not significantly different between the two groups. Flunarizine (10 mg) is effective in patients with migrainous vertigo who suffer from considerable vestibular symptoms.

• Authors: Anjali Lepcha, Sophia Amalanathan, Ann Mary Augustine, Amit Kumar Tyagi, Achamma Balraj
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 271 Issue 11 Pg. 2931-6 (Nov 2014) ISSN: 1434-4726 [Electronic] Germany
• PMID: 24166742 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Calcium Channel Blockers
• Histamine Agonists
• Histamine Antagonists
• Acetaminophen
• Flunarizine
• Betahistine

Topics

• Acetaminophen (therapeutic use)
• Adolescent
• Adult
• Aged
• Betahistine (therapeutic use)
• Calcium Channel Blockers (adverse effects, therapeutic use)
• Disorders of Excessive Somnolence (chemically induced)
• Drug Therapy, Combination
• Female
• Flunarizine (adverse effects, therapeutic use)
• Histamine Agonists (therapeutic use)
• Histamine Antagonists (therapeutic use)
• Humans
• Male
• Middle Aged
• Migraine Disorders (complications, drug therapy)
• Vertigo (etiology, prevention & control)
• Weight Gain (drug effects)
• Young Adult