Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine

Aim: New disease-specific and mechanism-based treatments for migraine that share good evidence of efficacy have recently been introduced. However, due to reimbursement problems with insurance companies and high costs, classical anti-migraine drugs continue to be used. The objective of this study was...

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Main Authors: Devrimsel Harika Ertem, Faik Ilik, Mustafa Kemal Ilik
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/6/545
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author Devrimsel Harika Ertem
Faik Ilik
Mustafa Kemal Ilik
author_facet Devrimsel Harika Ertem
Faik Ilik
Mustafa Kemal Ilik
author_sort Devrimsel Harika Ertem
collection DOAJ
description Aim: New disease-specific and mechanism-based treatments for migraine that share good evidence of efficacy have recently been introduced. However, due to reimbursement problems with insurance companies and high costs, classical anti-migraine drugs continue to be used. The objective of this study was to assess the clinical efficacy and tolerability of flunarizine for the preventive treatment of episodic migraine without aura in a Turkish cohort, concentrating on alterations in headache frequency, pain intensity, and migraine-related disability as measured by MIDAS scores within a practical clinical environment. Methods: Clinical and demographic data of 243 patients with episodic migraine without aura (175 females, 68 males; mean age 33.9 years) were evaluated. Headache frequency, side effects of flunarizine, pain intensity, and MIDAS scores were recorded during initial and 3-month follow-up periods. Results: After three months of flunarizine treatment, significant improvements were observed in headache parameters. The mean Numeric Pain Rating Scale (NPRS) score, the mean MIDAS score, and the monthly migraine attack frequency declined significantly (all <i>p</i> values < 0.001). Adverse events were reported in 21.8% of patients, most commonly weight gain and tiredness, followed by mood changes, gastrointestinal symptoms, and numbness or tingling. Patients experiencing side effects were significantly older (<i>p</i> = 0.023), though side effects did not impact treatment efficacy. Regression analysis identified no significant predictors of disability improvement. Conclusion: Our results demonstrated that flunarizine had considerable short-term efficacy in decreasing the frequency of migraine attacks, alleviating headache severity, and reducing migraine-related disability among patients experiencing episodic migraine without aura. Although mild to moderate side effects were fairly prevalent, especially in older individuals, they did not compromise the effectiveness of the treatment. Notably, early adverse events occurring within the first two weeks resulted in treatment discontinuation for some patients, highlighting the necessity for vigilant monitoring during the initial phase of treatment.
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spelling doaj-art-48ff66e90fd64382b18e97a080ec2f2d2025-06-25T13:34:57ZengMDPI AGBrain Sciences2076-34252025-05-0115654510.3390/brainsci15060545Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic MigraineDevrimsel Harika Ertem0Faik Ilik1Mustafa Kemal Ilik2Department of Neurology, Silivri Anatolian Hospital, 34570 Istanbul, TürkiyeDepartment of Neurology, Medova Hospital Affiliated with Medical Faculty, KTO Karatay University, 42208 Konya, TürkiyeDepartment of Neurosurgery, Buyuksehir Hospital, 42060 Konya, TürkiyeAim: New disease-specific and mechanism-based treatments for migraine that share good evidence of efficacy have recently been introduced. However, due to reimbursement problems with insurance companies and high costs, classical anti-migraine drugs continue to be used. The objective of this study was to assess the clinical efficacy and tolerability of flunarizine for the preventive treatment of episodic migraine without aura in a Turkish cohort, concentrating on alterations in headache frequency, pain intensity, and migraine-related disability as measured by MIDAS scores within a practical clinical environment. Methods: Clinical and demographic data of 243 patients with episodic migraine without aura (175 females, 68 males; mean age 33.9 years) were evaluated. Headache frequency, side effects of flunarizine, pain intensity, and MIDAS scores were recorded during initial and 3-month follow-up periods. Results: After three months of flunarizine treatment, significant improvements were observed in headache parameters. The mean Numeric Pain Rating Scale (NPRS) score, the mean MIDAS score, and the monthly migraine attack frequency declined significantly (all <i>p</i> values < 0.001). Adverse events were reported in 21.8% of patients, most commonly weight gain and tiredness, followed by mood changes, gastrointestinal symptoms, and numbness or tingling. Patients experiencing side effects were significantly older (<i>p</i> = 0.023), though side effects did not impact treatment efficacy. Regression analysis identified no significant predictors of disability improvement. Conclusion: Our results demonstrated that flunarizine had considerable short-term efficacy in decreasing the frequency of migraine attacks, alleviating headache severity, and reducing migraine-related disability among patients experiencing episodic migraine without aura. Although mild to moderate side effects were fairly prevalent, especially in older individuals, they did not compromise the effectiveness of the treatment. Notably, early adverse events occurring within the first two weeks resulted in treatment discontinuation for some patients, highlighting the necessity for vigilant monitoring during the initial phase of treatment.https://www.mdpi.com/2076-3425/15/6/545flunarizineheadachemigraineprophylaxispreventive treatmentobservational study
spellingShingle Devrimsel Harika Ertem
Faik Ilik
Mustafa Kemal Ilik
Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
Brain Sciences
flunarizine
headache
migraine
prophylaxis
preventive treatment
observational study
title Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
title_full Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
title_fullStr Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
title_full_unstemmed Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
title_short Still Relevant, Still Effective: A Retrospective Observational Cohort Study on Real-Life Use of Flunarizine in Episodic Migraine
title_sort still relevant still effective a retrospective observational cohort study on real life use of flunarizine in episodic migraine
topic flunarizine
headache
migraine
prophylaxis
preventive treatment
observational study
url https://www.mdpi.com/2076-3425/15/6/545
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