Tag Archives: Flunarizine

Preventive Treatment for Migraine

Migraine is a common episodic headache disorder characterized by attacks that consist of various combinations of headache and neurologie, gastrointestinal, and autonomie symptoms. It has a one-year prevalence of approximately 18% in women, 6% in men, and 4% in children. The second edition of the International Classification of Headache Disorders (ICHD-2) subclassifies migraine into migraine… Read More »

Specific Migraine-Preventive Agents

β-Adrenergic Blockers β-blockers, the most widely used class of drugs in prophylactic migraine treatment, are approximately 50% effective in producing a greater than 50% reduction in attack frequency. Rabkin et al. serendipitously discovered propranolol’s effectiveness in headache treatment in patients who were being treated for angina. The Agency for Healthcare Policy and Research (AHCPR) Technical… Read More »

Specific Migraine-Preventive Agents: Serotonin Antagonists

The antiserotonin, migraine-preventive drugs are potent 5-HT2B- and 5-HT2C-receptor antagonists, whereas metachlorophenyl piperazine (mCPP), a 5-HT2B- and 5-HT2C-receptor agonist, induces migraine in susceptible individuals. Methysergide, cyproheptadine, and pizotifen, effective migraine prophylactic drugs, are 5-HT2B-and 5-HT2C-receptor antagonists, whereas ketanserin, a selective 5-HT2A- and a poor 5-HT2B- and 5-HT2C-receptor antagonist, is not. mCPP, a major metabolite of… Read More »

Specific Migraine-Preventive Agents: Calcium-Channel Antagonists

Calcium, in combination with a calcium-binding protein such as calmodulin or troponin, regulates many functions, including muscle contraction, neurotransmitter and hormone release, and enzyme activity. Its extracellular concentration is high; its intracellular free concentration is 10,000-fold smaller. The concentration gradient is established by membrane pumps and the intracellular sequestering of free calcium. When stimulated, the… Read More »


Migraine is a primary headache. Diagnosis can be made from the history. However, investigation may be required to exclude headache of other aetiology. Pathophysiology There are vascular and neural hypotheses. The ophthalmic division of the trigeminal nerve supplies painful structures within the head. Stimulation of the trigeminal ganglion releases a peptide from trigeminal neurones which… Read More »

Which of the drugs appears to be the most effective preventative drug for children and adolescents with headaches?

Which of the following appears to be the most effective preventative medication for children and adolescents with migraine headaches? A. Propranolol (Inderal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Levetiracetam (Keppra) E. Zonisamide (Zonegran) The answer is C. Data on preventative medication for children and adolescents with migraine headaches is sparse, as noted by the… Read More »

Which one of the drugs is a proven agent, available in the US, for the preventative treatment of migraine headaches in children?

Which one of the following medications is a proven efficacious agent, available in the United States, for the preventative treatment of migraine headaches in children? A. Propranolol (Inderal) B. Flunarizine C. Cyproheptadine (Periactin) D. Divalproex sodium (Depakote) E. None of the above The answer is E. Flunarizine, a Ca-channel blocker, is probably effective for the… Read More »


Several types of headaches are unique to sleep and its disorders. Thus, evaluation of headache should also include temporal information during the 24-hour cycle, which may offer clues to the diagnosis. Key headaches that are classically associated with sleep include cluster headaches, migraines, chronic paroxysmal hemicrania, and hypnic headaches. Additionally, sleep apnea can help trigger… Read More »