Flunarizine is a class IV
calcium antagonist with a pharmacological profile which suggests its therapeutic potential in a number of neurological and
cerebrovascular disorders. It is an effective prophylactic treatment for common or
classic migraine in children and adults, and it appears at least as effective as a number of other agents which act by different pharmacological mechanisms, including
pizotifen (
pizotyline),
cinnarizine,
methysergide,
nimodipine,
metoprolol,
propranolol,
aspirin and
cyclandelate.
Flunarizine is also effective in reducing the frequency of
seizures, when used as an 'add-on' treatment, in some patients with partial or generalised
epilepsy resistant to maximal
therapy with a combination of several conventional
antiepileptic drugs. Placebo-controlled studies show that
flunarizine is effective in the treatment of
vertigo and associated symptoms of either peripheral or central origin, and in the treatment of
cerebrovascular insufficiency where psychological symptoms, rather than
vertigo, are the primary symptoms. In the treatment of
vertigo,
flunarizine appears at least as effective as
cinnarizine and more effective than
nicergoline,
betahistine dichlorhydrate,
pentoxifylline (
oxpentifylline) and
vincamine.
Flunarizine therefore is useful in the prophylaxis of
migraine, an effective treatment for
vertigo and a worthwhile alternative as 'add-on'
therapy in patients with
epilepsy resistant to conventional drugs.