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Rising dose study of safety and tolerance of flunarizine.

Abstract
In a recent NIH-sponsored parallel-group placebo-controlled blinded study of flunarizine for the treatment of partial-onset seizures, the flunarizine serum concentration was controlled to a constant level among patients in order to reduce response variability. Flunarizine was found to exhibit modest anti-epileptic efficacy. A potential criticism of this study is that the chosen controlled concentration was too low to determine optimal efficacy. As a participating center in this study we investigated the effect of higher doses of open-label flunarizine on seizure frequency in 16 patients with refractory partial seizures. Following the completion of the blinded placebo/flunarizine phase, all patients were initiated at the flunarizine dose calculated to result in a serum concentration of 60 ng.ml-1. The dose was subsequently increased each 8-12 weeks to a maximum of 2.7 times the initial dose. On the initial maintenance flunarizine dose, seizure control was improved, with an average seizure reduction of 47% compared to pre-blinded-phase baseline. When higher doses were administered, adverse reactions were more common yet improved seizure control did not occur in most patients. These findings complement those of the concentration-controlled NIH study and suggest that appropriate flunarizine doses were utilized in that study.
AuthorsA Handforth, T Mai, D M Treiman
JournalEuropean journal of clinical pharmacology (Eur J Clin Pharmacol) Vol. 49 Issue 1-2 Pg. 91-4 ( 1995) ISSN: 0031-6970 [Print] Germany
PMID8751028 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Anticonvulsants
  • Flunarizine
Topics
  • Adult
  • Anticonvulsants (administration & dosage, adverse effects, blood)
  • Epilepsies, Partial (blood, drug therapy)
  • Female
  • Flunarizine (administration & dosage, adverse effects, blood)
  • Humans
  • Male
  • Middle Aged

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