INTRODUCTION: This retrospective review is to evaluate the efficacy of a fixed combination of low doses of long - acting propranolol and flunarizine, when flunarizine mono therapy is ineffective in migraine
METHODS: Thirty- five patients (ages 21-57 years; average 36.5 years; male-female ratio, 1: 4) compatible with the diagnosis of migraine without aura received an initial single evening dose of flunarizine of 10 mg for a period of 8 weeks and none of them showed change of migraine attacks per month. These patients were divided into two treatment groups - Group A received a fixed combination of 20mg. long acting propranolol and 5mg. flunarizine and group B received a fixed combination of 40mg. long acting propranolol and 10mg. flunarizine for a period of 8 weeks, without a "drug-free" period of observation. The patients were assessed at the end of 8 weeks period for differences in attack frequency, duration and intensity compared to the baseline as well as in both the treatment groups.
RESULTS: Both groups showed significant reduction in the mean (±SD) of monthly migraine frequency, headache intensity, and headache duration (Wilcoxon Signed Rank test, significant at p≤ 0.01) when compared to baseline parameters. However, there was no significant difference in frequency, duration and severity for both doses groups when compared. There was no adverse effect observed.
DISCUSSION AND CONCLUSION: This study suggests that the fixed dose combination of 20 mg propranolol and 5 mg flunarizine could be a new treatment initiative, especially for patients in whom flunarizine mono therapy is ineffective in migraine prophylaxis