Flunarizine for Prophylactic Treatment of Childhood Migraine

Objective: To determine the effectiveness of flunarizine for migraine prophylaxis in children. Patients and Method: Children aged between 7 and 15 years who had the indication for prophylactic treatment of migraine were recruited into a prospective study at the Department of Pediatrics, Ramathibodi Hospital, from January 1st to December 31st 1999. After verbal consent was obtained, flunarizine was admin-istered either at 5-mg daily in those who had never received it or at 10-mg daily in those who previously took this drug within one year. Serial evaluation for the severity of migraine including duration, intensity, and frequency of headache attacks was performed every 2 weeks for 6 months. Results: Twenty-one children (10 boys, 11 girls) with a mean age of 11.3 + 2.48 years (range 7-15 years) were enrolled in the study. There were ten children who had migraine with aura. Initially, 5-mg daily and 10-mg daily of flunarizine were administered in 19 and 2 patients respectively. The dosage was increased to 10-mg daily after two weeks in 5 patients because of the unresponsiveness to the initial dose. Improvement was observed in 14 patients (66%) including 13 of 14 patients who received 5-mg daily and 1 of 7 patients who received 10 mg daily. Five patients (23%) had no recurrent attack. Nine patients (42%) had more than 50%-reduction of frequency of migraine and 3 of these had either shorter duration or less intensity of the attack. Clinical improvement was observed between 2 and 4 weeks after initiation of treatment. There was no adverse effect observed. Conclusion: This is a preliminary result demonstrating that flunarizine is one of the effective drugs for migraine prophylaxis in children