No abstract available.
Animals ; Compensation and Redress* ; Flunarizine* ; Rats*

PURPOSE: The present study was designed to explore the potential of flunarizine for cisplatin induced painful uremic neuropathy in rats. METHODS: Cisplatin (2 mg/kg; i.p., for 5 consecutive days) was administered and renal uremic markers i.e., serum creatinine were estimated on days 4 and 25. Behavioral changes were assessed in terms of thermal hyperalgesia (hot plate, plantar, tail immersion, and tail flick tests at different time intervals). Biochemical analysis of total calcium, superoxide anion, DNA, and transketolase, and myeloperoxidase activity in tissue samples was also performed. Furthermore, flunarizine (100, 200, and 300 microM/kg; p.o., for 21 consecutive days) was administered to evaluate its potency on uremic neuropathy, and the results were compared with those for the carbamazepine-treated (30 mg/kg; p.o., for 21 consecutive days) groups. RESULTS: Flunarizine attenuated the cisplatin-induced uremic neuropathy, and the degree of behavioral and biochemical changes in serum and tissue samples in a dose dependent manner. The medium and high doses of flunarizine were shown to produce a significant effect on cisplatin induced painful uremic neuropathy. CONCLUSIONS: Our results indicate the potential of flunarizine for anti-oxidative, anti-inflammatory, and neuroprotective actions. Therefore, it may have use as a novel therapeutic agent for the management of painful uremic neuropathy.
Animals ; Calcium ; Cisplatin ; Creatinine ; DNA ; Flunarizine ; Hyperalgesia ; Immersion ; Neurotoxins ; Peroxidase ; Rats ; Superoxides ; Transketolase ; Uremia

Effects of various peripheral vasoconstrictors on isolated porcine basilar and posterior communicating arteries(BA and PCA) were investingated and effected of flunarizine on the contractile responses were compared with those of a vasodilator, nitroglycerin. KCl elicited dose-dependent contractions in BA and PCA. 50mM KCl-induced contraction was not affected by nitroglycerin but dose-dependently inhibited by nimodipin and flunarizine in both rings. Epinephrine produced contractile response of BA and PCA in a dose-dependent fashion, but norepinephrine or phenylephrine did not cause obvious contraction by itself. Norepinephrine and phenylephrine elicited dose-dependent contractions in both rings treated with 10 -6M propranolol and the epinephrine-induced contractions were potentiated by pretreatment with propranolol, 5-hydroxytryptamine and histamine contracted BA and PCA in a dose-dependent manner and the contraction of PCA was more prominent than that of BA. In PCA rings, 10(-6)M 5-hydroxytryptamine and 10 -6M orepinephrine-induced contractions were not changed by nitroglycerin but inhibited by flunarizine in a dose-dependent manner. Small doses of flunarizine inhibited gradually both drug-induced contractions and large doses(3.5 x 10(-6) and 10(-6)M) steeply inhibit ed the contractions. Then the slopes of inhibitory curves in both cases were biphasic. Above results suggest that responsibility of catecholamine in porcine brain artery is more prominent in alpha-adrenoceptors than in beta-adrenoceptors, and inhibitory effect of flunarizine on brain artery results from inhibition of calcium influx through stimulated receptor-operated calcium channel(ROC) and potential-operated calcium channel(POC) .
Arteries* ; Brain* ; Calcium ; Epinephrine ; Flunarizine* ; Histamine ; Nitroglycerin ; Norepinephrine ; Passive Cutaneous Anaphylaxis ; Phenylephrine ; Propranolol ; Serotonin ; Vasoconstrictor Agents

Hemiplegic migraine is characterized by the occurrence of migraine attacks with unilateral weakness. The attack usually starts in childhood, adolescence, or early adulthood. The diagnosis may be delayed if there is no relevant family history. We experienced two cases of hemiplegic migraine of 8 and 14 years old girls whose neuroimaging studies including MRA showed no abnormal findings in the acute phases and the ictal EEG findings also revealed normal. The hemiplegic attacks associated with sensory disturbance were improved by calcium channel blocker(Flunarizine). Hemiplegic migraine should be considered in the differential diagnosis of a pediatric hemiparesis even if there is no familial migraine history.
Adolescent ; Calcium Channels ; Diagnosis ; Diagnosis, Differential ; Electroencephalography ; Female ; Flunarizine ; Humans ; Migraine Disorders* ; Neuroimaging ; Paresis

OBJECTIVETo investigate the preventive effect of behavioral therapy plus flunarizine in children with migraine.

METHODSNinety pediatric patients with migraine between January 2011and January 2014 were randomly divided into treatment group (45 cases) and control group (45 cases). The treatment group received behavioral therapy in addition to oral flunarizine, while the control group received oral flunarizine alone. All patients were followed up for 3 months to evaluate the therapeutic effect by the Pediatric Migraine Disability Assessment Score (PedMIDAS) and improved Bussone headache index.

RESULTSThere were no significant differences in PedMIDAS (P>0.05) and improved Bussone headache index (P>0.05) between the control and treatment groups before treatment. Significant differences were observed in PedMIDAS (16±8 vs 20±10; P<0.05) and improved Bussone headache index (25±18 vs 37±21; P<0.05) between the two groups after 3 months of treatment.

CONCLUSIONSPreventive treatment of behavioral therapy plus oral flunarizine shows a better clinical efficacy than oral flunarizine alone in children with migraine and holds promise for clinical application.

Adolescent ; Behavior Therapy ; Child ; Combined Modality Therapy ; Female ; Flunarizine ; therapeutic use ; Humans ; Male ; Migraine Disorders ; therapy

OBJECTIVE: To compare the clinical effect of electroacupuncture at Siguan points and flunarizine hydrochloride capsule on migraine of liver yang hyperactivity. METHODS: A total of 110 patients with migraine of liver yang hyperactivity were randomly divided into an electroacupuncture group (55 cases, 2 cases dropped off) and a western medication group (55 cases, 2 cases dropped off). In the electroacupuncture group, electroacupuncture was applied at Siguan points (Hegu [LI 4] and Taichong [LR 3]), with disperse-dense wave of 2 Hz/100 Hz in frequency and current intensity of 0.1-1 mA, 30 min each time, once a day, 5 times per week for 4 weeks. Flunarizine hydrochloride capsule was given orally in the western medication group, 10 mg a day for 4 weeks. The visual analogue scale (VAS) score and the migraine attack days were observed before and after treatment, during follow-up of 1, 3 and 6 months, and the migraine symptom score was observed before and after treatment in the two groups. RESULTS: After treatment, during follow-up of 1, 3 and 6 months, the VAS scores and the migraine attack days in the two groups were decreased compared with before treatment (Ｐ<0.05), and above indexes in the electroacupuncture group were lower than the western medication group (Ｐ<0.05). After treatment, the migraine symptom scores in the two groups were decreased (Ｐ<0.05), the change in the electroacupuncture group was greater than the western medication group (Ｐ<0.05). CONCLUSION Electroacupuncture at Siguan points could effectively reduce headache intensity and migraine attack days, relieve migraine symptoms in patients with migraine of liver yang hyperactivity, and the efficacy is superior to oral flunarizine hydrochloride capsules.
Acupuncture Points ; Electroacupuncture ; Flunarizine/therapeutic use* ; Humans ; Liver ; Migraine Disorders/therapy*

The aim of this study was to investigate the role of Ca2+-channel blockers in norepinephrine (NE) release from rat hippocampus. Slices and synaptosomes were incubated with [3H]-NE and the releases of the labelled products were evoked by 25 mM KCl stimulation. Nifedipine, diltiazem, nicardipine, flunarizine and pimozide did not affect the evoked and basal release of NE in the slice. But, diltiazem, nicardipine and flunarizine decreased the evoked NE release with a dose-related manner without any change of the basal release from synaptosomes. Also, a large dose of pimozide produced modest decrement of NE release. omega-conotoxin (CTx) GVIA decreased the evoked NE release in a dose-dependent manner without changing the basal release. And omega-CTxMVIIC decreased the evoked NE release in the synaoptosomes without any effect in the slice, but the effect of decrement was far less than that of omega-CTxGVIA. In interaction experiments with omega-CTxGVIA, omega-CTxMVIIC slightly potentiated the effect of omega-CTxGVIA on NE release in the slice and synaptosomal preparations. These results suggest that the NE release in the rat hippocampus is mediated mainly by N-type Ca2+-channels, and that other types such as L-, T- and/or P/Q-type Ca2+-channels could also be participate in this process.
Animals ; Diltiazem ; Flunarizine ; Hippocampus ; Nicardipine ; Nifedipine ; Norepinephrine* ; omega-Conotoxins ; Pimozide ; Rats* ; Synaptosomes*

To systematically evaluate the efficacy and safety of acupuncture versus Flunarizine hydrochloride in the treatment of migraine. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and ClinicalTrail.gov were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to January 8, 2020. Randomized controlled trial(RCT) for acupuncture versus Flunarizine in the treatment of migraine were screened out according to inclusion criteria and exclusion criteria. The included studies were evaluated with the Cochrane bias risk assessment tool. The included studies was conducted by RevMan 5.3, and the outcome indicators were evaluated for evidence quality and strength of recommendation by the GRADE system. A total of 1 033 literatures were retrieved, and 23 studies were finally included. Except for 4 multiarm tests, the total sample size was 1 548, including 785 in acupuncture group and 763 in Flunarizine group. The overall quality of the included studies was not high. Meta-analysis results showed that the acupuncture group was superior to the Flunarizine group in reduction of headache frequency(SMD=-1.00, 95%CI[-1.45,-0.54], P<0.000 1). In reduction of headache intensity, acupuncture group was superior to Flunarizine group(SMD=-1.05, 95%CI[-1.41,-0.68], P<0.000 01). In reduction of headache duration, acupuncture group was superior to Flunarizine group(SMD=-1.42, 95%CI[-1.83,-1.02], P<0.000 1). The acupuncture group was superior to Flunarizine group(MD=-0.17, 95%CI[-0.21,-0.13], P<0.000 01) in reduction of the painkillers taking frequency. The acupuncture group was superior to Flunarizine group(SMD=-0.94, 95%CI[-1.35,-0.52], P<0.000 1) in allevia-tion of paroxysmal symptoms, such as nausea and vomiting. The GRADE system showed that the evidence level of the above indicators was extremely low, and the strength of recommendation was low. As for the occurrence of adverse reactions, the adverse reactions reported in the acupuncture group included in the study were all mild adverse reactions, like drowsiness, subcutaneous bleeding, local pain, subcutaneous hematoma and dizziness needle. The available evidence showed that acupuncture has a better efficacy than Flunarizine hydrochloride in the treatment of migraine in adult patients. However, due to the high bias risk in the included studies, the conclusions of this study shall be adopted with caution, and more high-quality studies shall be carried out for verification in the future.
Acupuncture Therapy ; Flunarizine/therapeutic use* ; Humans ; Migraine Disorders/therapy* ; Treatment Outcome

PURPOSE: The aim of this study was to estimate the efficacy and safety of flunarizine in the treatment of pediatric headaches. METHODS: We conducted a retrospective analysis of clinical records of children aged between 4 and 19 years who were treated with flunarizine for headache at the Chosun university hospital between April 2006 and December 2012. Flunarizine was initially prescribed to patients 5 mg daily and was then escalated once in 7 patients because of the unresponsiveness to the initial dose. We evaluated the frequency, duration, severity, and disability of headache before and after the treatment of flunarizine. Effective treatment was defined as a reduction in the frequency of individual attacks by at the least 50%. RESULTS: Eighty five patients were identified, but 23 were excluded due to missing records. Sixty two children were included in the study: 18 boys and 44 girls with a mean age of 11 years. The diagnostic categories included migraine (27), tension type headache (7), others (28). The mean frequency of attack was 15.1+/-8.9 per month. Good outcome was observed 54.8% (34/62) in 1 month, 70.4% (38/54) in 3 month, and 80.8% (42/52) in 6 month. Adverse effects were seen in 15 (24.2%): worsening of headache (4), sedation (3), weight gain/increased appetite (2), dizziness (1), drowsiness (1) and others (4). Flunarizine was discontinued due to adverse effects in 6 patients, which includes worsening of headache (4), muscle ache (1), and tremor (1). In addition, it was discontinued due to lack of efficacy in seven patients. CONCLUSION: Flunarizine appears to be effective and safe in pediatric headache in our study. However, further studies are needed.
Appetite ; Child ; Dizziness ; Female ; Flunarizine* ; Headache* ; Humans ; Migraine Disorders ; Muscles ; Retrospective Studies ; Sleep Stages ; Tension-Type Headache ; Tremor

BACKGROUND & SIGNIFICANCE: Parkinsonism is a rare but well-known side effect of some calcium channel blockers, mainly cinnarizine and flunarizine. Not a few cases of flunarizine-induced parkinsonism have been reported in Europe. Although flunarizine is widely prescribed for vertigo, cerebral blood flow disturbance and migraine prophylaxis, there is no case report of flunarizine-induced parkinsonism in Korea. CASE : We experienced 3 patients who had parkinsonism after treatment with flunarizine for between 10 weeks and 14 weeks. Two patients also showed depressive mood during treatment. When flunarizine therapy was discontinued, one patients show complete improvement 4 months after withdrawal. Two patients had so severe parkinsonism that they should take levodopa. All of these patients showed marked improvement in spite of dose-reduction and ceasing of levodopa. All patients met the diagnostic criteria for flunarizine-induced parkinsonism presented by Garcia-Rultz and colleagues in 1992. Detailed clinical features and laboratory findings are described with brief review of related articles. CONCLUSION: We reported 3 cases of clinically suspected flunarizine-induced parkinsonism. To our knowledge, this is the first case report on flunarizine-induced parkinsonism in Korea. In our cases, as previously reported, aging seems to be a critical risk factor for developing flunarizine-induced parkinsonism. So, we conclude that elderly patients should be treated with flunarizine as seldom as possible and if treated, they should be followed carefully to disclose early signs of parkinsonism.
Aged ; Aging ; Calcium Channel Blockers ; Cinnarizine ; Europe ; Flunarizine ; Humans ; Korea ; Levodopa ; Migraine Disorders ; Parkinsonian Disorders ; Risk Factors ; Vertigo