Flunarizine, a Ca-antagonist with demonstrated antimigraine properties, and
indoprofen, an anti-inflammatory non-steroidal agent, were used in the treatment of daily
chronic headache. Forty-two migraineurs with interval
headache (MIH) were treated with
flunarizine in a 6-month open trial, while
indoprofen was administered to 23 patients with MIH and 7 with chronic
tension headache (CTH) in a 2-month, double-blind, cross-over placebo-controlled study.
Flunarizine was found effective in over 65% of the patients, while
indoprofen was able to improve
headache severity in only 30% of the subjects. In the responder patients, the effectiveness of both drugs is more pronounced in MIH, and seems to be ascribable to the ability of the treatments to reduce number and severity of attacks. A higher incidence of previous affective disturbances is found in non-responsive cases. The analysis of factors converting episodic into
chronic headache shows slight but not significant differences between responders and non-responders. An impairment of plasma
beta-endorphin levels, in the presence of normal
ACTH,
cortisol and nociceptive RIII threshold values, characterizes daily
chronic headache (DCH) patients. Moreover,
indoprofen does not significantly affect these
biological and neurophysiological parameters independently of the therapeutic response.