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Comparative Efficacy of Cyclandelate versus Flunarizine in the Prophylactic Treatment of Migraine

  • Section 2: Clinical Studies
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Summary

In a double-blind, parallel-group randomised trial of 3 months’ duration, the efficacy of cyclandelate 800mg twice daily in migraine prophylaxis was compared with that of flunarizine 5mg daily in 40 patients. In comparison with placebo and baseline values, both drugs significantly relieved symptoms of migraine as assessed by indices of pain total index, headache index, analgesic consumption and number of migraine days. Patients taking flunarizine experienced side effects such as drowsiness, weight gain and asthenia, while the most common complaint reported with cyclandelate was gastric upset.

These results suggest that cyclandelate may be a useful alternative in migraine pro-phylaxis.

Résumé

Une étude randomisée en double-insu avec groupes parallèles, d’une durée de 3 mois, a permis de comparer l’efficacité du cyclandélate (800 mg deux fois par jour) à celle de la flunarizine (5 mg par jour) dans la prophylaxie de la migraine chez 40 patients. Par rapport au placebo et aux valeurs de base, les deux médicaments ont significativement réduit les symptômes migraineux évalués par l’index total de la douleur, l’index de céphalée, la consommation d’analgésiques et le nombre de jours de migraine. Les patients traités par la flunarizine ont présenté des effets secondaires à type de somnolence, de gain de poids et d’asthénie alors que les troubles gastriques ont été les principales manifestations indésirables observées sous cyclandélate.

Ces résultats permettent de penser que le cyclandélate peut constituer une alternative utile dans le traitement prophylactique de la migraine.

Riassunto

In un gruppo di ricerche randomizzate a doppio cieco délia durata di 3 mesi, su 40pazienti, l’efficacia di un trattamento con 800 mg di ciclandelato due volte al giorno nella profilassi dell’emicrania, venne paragonata a quella della flunarizina alla dose di 5 mg al giorno. Ambedue i farmaci, paragonati con il placebo ed i valori di base, hanno evidenziato in maniera significativa che i sintomi di emicrania erano valutabili dall’indice totale di sofferenza, dall’Vindice di cefalea, dal consumo di analgesico e dalla durata-giorni dell’emicrania. I pazienti trattati con flunarizina ebbero effetti collaterali quali sonnolenza, aumento di peso ed astenia, mentre il disturbo più comune lamentato dai pazienti trattati con il ciclandelato era insofferenza gastrica.

Questi risultati suggeriscono che il ciclandelato può rappresentare un’ utile alternativa nella profilassi dell’emicrania.

Samenvatting

In een 3 maanden durende aselecte Studie met 40 patiënten werd de effectiviteit van cyclandelaat, toegediend in doses van 2 maal 800 mg per dag, vergeleken met die van flunarizine, 5 mg per dag, bij de profylaxe van migraine. In vergelijking met de placebo- en uit-gangswaarden was er bij beide geneesmiddelen een signiflcante vermindering van de migrai-nesymptomen waar te nemen. Dat blijkt uit de scores van de globale pijnindex, de hoofdpijn index, het analgeticagebruik en het aantal migrainedagen. Proefpersonen die flunarizine toegediend kregen, rapporteerden bijwerkingen zoals slaperigheid, gewichtstoename en asthenie. Bij het gebruik van cyclandelaat werden maagklachten als meest voorkomend gemeld.

Deze resultaten duiden er op dat cyclandelaat een waardevol alternatief kan zijn bij de profylaxe van migraine.

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References

  • Hoc Committee on Classification of Headache of the NIH. Journal of the American Medical Association 179: 717–718, 1962

    Article  Google Scholar 

  • Amery AK. Cerebral hypoxia and migraine. In Amery et al. (Eds) The pharmacological basis of migraine therapy, pp. 118–133, Pitman, London, 1984

    Google Scholar 

  • Anthony M. The biochemistry of migraine. In Rose (Ed.) Handbook of clinical neurology. Headache Vol. 4 (48), pp. 85–105, Elsevier Science Publishers, Amsterdam, 1986

    Google Scholar 

  • Bono G, Micieli G, Sances G, Calvani M, Nappi G. L-5HTP treatment in primary headaches: an attempt at clinical identification of responsive patients. Cephalalgia 4: 159–165, 1984

    Article  PubMed  CAS  Google Scholar 

  • Diamond S, Schenbaum H. Flunarizine, a calcium channel blocker, in the prophylactic treatment of migraine. Headache 23: 39–42, 1983

    Article  PubMed  CAS  Google Scholar 

  • Greenslade FC, Scott CK, Newquist KL, Krider KM, Chasin M. Heterogeneity of biochemical action among vasodilators. Journal of Pharmaceutical Science 71: 94–101, 1982

    Article  CAS  Google Scholar 

  • Hall P. Cyclandelate in the treatment of cerebral arteriosclerosis. Journal of American Geriatrics Society 24: 41–45, 1976

    CAS  Google Scholar 

  • Hosobuchi Y, Baskin DS, Woo SK. Reversal of induced ischemic neurological deficits in gerbils by the opiate antagonist naloxone. Science 215: 69–71, 1982

    Article  PubMed  CAS  Google Scholar 

  • Lance JW, Lambert GA, Goadsby PJ, Duckworth JW. Brainstem influences on the cephalic circulation: experimental data from cat and monkey of relevance to the mechanism of migraine. Headache 23: 258–265, 1983

    Article  PubMed  CAS  Google Scholar 

  • Lauritzen M. Cerebral blood flow regulation of rat brain after spreading depression. Journal of Cerebral Blood Flow and Metabolism 3: 254–255, 1983

    Article  Google Scholar 

  • Leão AAP. Spreading depression of activity in the cerebral cortex. Journal of Neurophysiology 7: 359–390, 1944

    Google Scholar 

  • Louis P. A double blind placebo-controlled prophylactic study of flunarizine in migraine. Headache 21: 235–239, 1981

    Article  PubMed  CAS  Google Scholar 

  • Manzoni GC, Bono C, Sacquegna T, Manna V, Lanfranchi M, et al. Flunarizine in common migraine: Italian cooperative trial. I. Short-term results and responders’ definition. Cephalalgia 5 (Suppl. 2): 147–153, 1985

    Google Scholar 

  • Meyer JS, Hardenberg J. Clinical effectiveness of calcium entry blockers in prophylactic treatment of migraine and cluster headaches. Headache 23: 266–277, 1983

    Article  PubMed  CAS  Google Scholar 

  • Meyer JS, Nance M, Walker M, Zetusky WJ, Dowell RE. Migraine and cluster headache treatment with calcium antagonists supports a vascular pathogenesis. Headache 25: 358–367, 1985

    Article  PubMed  CAS  Google Scholar 

  • Middleton B, Middleton A, Miciak A, Edwards E, Whitten B, et al. The effect of cyclandelate on cholesterol synthesis. British Journal of Clinical Practice 38 (Suppl. 34): 43–49, 1984

    Google Scholar 

  • Nappi G, Bono G. Headaches and transient cerebral ischemia: comments on Welch’s report. In Critchley et al. (Eds) Advances in neurology, Vol. 33, pp. 41–44, Raven Press, New York, 1982

    Google Scholar 

  • Olesen J. The pathophysiology of migraine. In Rose (Ed.) Hand-book of clinical neurology, Vol. 4, pp. 59–83, Elsevier Science Publishers B.V., Amsterdam, 1986

    Google Scholar 

  • Peroutka SJ. The pharmacology of calcium channel antagonists: a novel class of anti-migraine agents? Headache 23: 278–283, 1983

    Article  PubMed  CAS  Google Scholar 

  • Peroutka SJ, Banghart SB, Allen GS. Relative potency and selectivity of calcium antagonists used in the treatment of migraine. Headache 24: 55–58, 1984

    Article  PubMed  CAS  Google Scholar 

  • Reich T. Cyclandelate: effect on circulatory measurements and exercise tolerance in chronic arterial insufficiency of the lowelimbs. Journal of American Geriatrics Society 25: 202–205, 1977

    CAS  Google Scholar 

  • Schaffler K. The antihypoxaemic effect of cyclandelate in man measured in human volunteers using computer-assisted oculodynamic methodology. British Journal of Clinical Practice 38 (Suppl. 34): 51–57, 1984

    Google Scholar 

  • Sicuteri F. Opioid receptor impairment — underlying mechanism in ‘pain diseases’? Cephalalgia 1: 77–82, 1981

    Article  PubMed  CAS  Google Scholar 

  • Sicuteri F, Anselmi B, Fanciullacci M. The serotonin (5-HT) theory of migraine. Advances in Neurology 4: 383–394, 1974

    CAS  Google Scholar 

  • Simonis AM, Ariens EJ, van den Broeke JJW. Non-competitive spasmolytics as antagonists of Ca++ induced smooth muscle contraction. Journal of Pharmacy and Pharmacology 23: 107–111, 1971

    Article  PubMed  CAS  Google Scholar 

  • Sorensen PS, Hansen K, Olesen J. A placebo-controlled, double-blind, cross-over trial of flunarizine in common migraine. Cephalalgia 6: 7–14, 1986

    Article  PubMed  CAS  Google Scholar 

  • van den Hoven WE, Hall DWR. Inhibition of human platelet aggregation by cyclandelate. British Journal of Clinical Practice 38 (Suppl. 34): 34–37, 1984

    Google Scholar 

  • van Nueten JM, Wellens D. Mechanisms of vasodilatation and anti-vasoconstriction. Angiology 30: 444–450, 1979

    Google Scholar 

  • Welch KMA. Impairment of cerebral serotonin and energy metabolism during ischemia: relevance to migraine. In Critchley et al. (Eds) Advances in neurology, Vol. 33, pp. 35–40, Raven Press, New York, 1982

    Google Scholar 

  • Wolff HF. Headache and other head pain. Oxford University Press, New York, 1963

    Google Scholar 

  • Young J, Hall P, Blakemore C. Treatment of the cerebral manifestations of arteriosclerosis with cyclandelate. British Journal of Psychiatry 124: 177–180, 1974

    Article  PubMed  CAS  Google Scholar 

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Nappi, G., Sandrini, G., Savoini, G. et al. Comparative Efficacy of Cyclandelate versus Flunarizine in the Prophylactic Treatment of Migraine. Drugs 33 (Suppl 2), 103–109 (1987). https://doi.org/10.2165/00003495-198700332-00019

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  • DOI: https://doi.org/10.2165/00003495-198700332-00019

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