flunarizine / Generic mfg. - LARVOL DELTA

Drugs for Migraine Prophylaxis. (PubMed, Dtsch Arztebl Int) - "The new prophylactic drugs against migraine are effective, well-tolerated, and especially useful for patients for whom traditional oral migraine prophylactic drugs and onabotulinum toxin A are ineffective, not tolerated, or contraindicated."

Journal • CNS Disorders • Migraine • Pain

Fu's Subcutaneous Needling treatment for migraine without aura: a randomized controlled trial protocol. (PubMed, Front Neurol) - "Therefore, this study aims to evaluate the analgesic efficacy of FSN and its impact on headache frequency and patients' quality of life (QoL) in comparison with guideline-recommended pharmacotherapy (flunarizine hydrochloride)...From baseline after 4 weeks of treatment. Secondary outcome measures including the Migraine-Specific Quality of Life (MSQOL) score, headache diary records, Migraine Disability Assessment (MIDAS), Visual Analog Scale (VAS) scores and near-infrared spectroscopy (NIRS) are also used to validate clinical efficacy."

Clinical • Journal • CNS Disorders • Migraine • Pain

Comparative Efficacy of Flunarizine and Propanolol in Pediatric Migraine (clinicaltrials.gov) - P=N/A | N=44 | Recruiting | Sponsor: Muhammad Aamir Latif

New trial • CNS Disorders • Migraine • Pain • Pediatrics

Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. (PubMed, Mov Disord) - "Current evidence from RCTs with at least 1 month of follow-up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher-quality clinical trials to improve treatment recommendations and guide decision-making for clinicians and patients with ET."

Journal • Review • CNS Disorders • Essential Tremor • Movement Disorders • Parkinson's Disease

A Novel Neuromodulation Method for Childhood Migraine: Comparing Noninvasive Pulsed Radiofrequency Therapy With Calcium Channel Blockers, a Randomized Controlled Trial. (PubMed, Pediatr Neurol) - "NiPRF is a safe and effective treatment for childhood migraine, with comparable short-term efficacy to CCBs. Its noninvasive nature and minimal side effects make it a promising alternative. Further studies should assess long-term efficacy and optimize protocols."

Journal • CNS Disorders • Migraine • Pain • Pediatrics

Middle meningeal artery lidocaine infusion for refractory migraine: First case report in Portugal (EHF-EHC 2025) - "Various pharmacologic classes were tried without benefit: antihypertensives and calcium channel blockers (propranolol, candesartan, flunarizine), antiepileptics (valproic acid, topiramate, oxcarbazepine), antidepressants (amitriptyline, nortriptyline, venlafaxine, fluvoxamine, sertraline, clomipramine), other preventives (prednisolone, oxitriptan, melatonin), cycles of botulinum toxin (PREEMPT protocol), monoclonal antibodies (galcanezumab, fremanezumab, erenumab), and atogepant. At the time of the procedure, the patient was on eptinezumab 100 mg and botulinum toxin every three months but continued to have daily headaches, with severe intensity and reliance on eletriptan for acute relief... MMA lidocaine infusion has been described in few cases, and this is, to our knowledge, the first reported in Portugal. It constitutes an invasive therapeutic approach that should be considered only as a rescue option for carefully selected patients with severely refractory migraine...."

Case report • Clinical • Anorexia • CNS Disorders • Migraine • Pain

Comparative efficacy and safety of topiramate versus flunarizine in migraine prophylaxis: A systematic review and meta -analysis (EHF-EHC 2025) - "Both topiramate and flunarizine generally demonstrated comparable efficacy in migraine prophylaxis, but flunarizine usage was associated with greater reduction in mean headache days at 8 weeks. Safety profiles were broadly similar, except that the topiramate group demonstrated higher incidences of paresthesia. Future RCTs should include larger sample sizes and use standardized reporting frameworks, including a core outcome set, to ensure consistency across studies and allow for more definitive and generalizable conclusions."

Clinical • Review • CNS Disorders • Migraine • Pain

Improvement in headache frequency does not alter pain sensitivity in chronic migraine treated with flunarizine (EHF-EHC 2025) - "Our findings indicate that although flunarizine significantly reduces headache frequency and related disability, it does not concurrently reduce pain sensitivity. Despite clinical improvement, the unchanged HPT, MPT, and PPT and increased CPT suggest persistent central sensitization or hypersensitivity. These findings align with our previous EEG results, demonstrating persistent abnormal occipital power despite clinical improvement."

CNS Disorders • Immunology • Migraine • Pain

Evaluating agreement between physician and ChatGPT in migraine prophylaxis selection: A pilot comparative study (EHF-EHC 2025) - "For each patient, the treating clinician selected a firstline preventive treatment among four options: amitriptyline, propranolol, topiramate or flunarizine. This pilot study demonstrates that ChatGPT can produce clinically coherent prophylactic treatment proposals in the management of migraine, with a statistically significant moderate agreement with experienced pain physicians. Further validation on larger cohorts is warranted to explore its potential as a clinical decision support tool. Fig."

CNS Disorders • Migraine • Pain

Assessing the effectiveness of personalized migraine treatment – A 22-year N-of-1 study (EHF-EHC 2025) - "No significant adverse effects were reported Topiramate (2006) was ineffective (+8.3% headache days); amitriptyline (2008) increased headache days (+20.4%) but reduced zolmitriptan use (−37.7%)...Erenumab (2020–2021) worsened both metrics (+4.1%, +37.8%). Flunarizine (2023) had modest benefit (−17%), and oxitriptan (2023–2024) had minimal effect. We report a case of chronic refractory migraine with long-term triptan overuse but without evidence of medication-overuse headache. This case raises the question of whether pharmacological resistance to preventives may be linked to preserved responsiveness to acute treatments"

CNS Disorders • Migraine • Mood Disorders • Obsessive-Compulsive Disorder • Pain • Personality Disorder

Primary cough headache – Botulinum toxin protocol treatment with a new indication? (EHF-EHC 2025) - "Indomethacin is the first-line treatment, but alternatives like acetazolamide or cerebrospinal fluid drainage have shown benefit in refractory or contraindicated cases...Initial treatment with flunarizine was ineffective... Trials with amitriptyline and propranolol were unsuccessful. Botulinum toxin is a safe and effective therapeutic option for PCH, especially in patients unresponsive to or intolerant of standard pharmacological treatments."

Clinical • Cardiovascular • CNS Disorders • Cough • Gastroenterology • Hypertension • Migraine • Otorhinolaryngology • Pain • Rare Diseases • Renal Disease • Respiratory Diseases • Sleep Disorder • Vertigo

Acupuncture in migraine prevention: High-quality evidence from double-dummy randomized controlled trials and its implications in clinical practice (EHF-EHC 2025) - "(2011, n=140) compared acupuncture with flunarizine and found higher ≥50% responder rates (56% vs. 37% at 16 weeks), and greater reductions in migraine days (−4.1 vs. −2.0 at week 16)...(2024, n=60) compared acupuncture with topiramate, reporting larger reductions in monthly migraine days (−5.6 vs. -2.8 at 12 weeks), higher ≥50% responder rates (33.3% vs. 6.7%), and fewer adverse events (10% vs. 26.7%). Limited high-quality double-dummy RCTs indicate that acupuncture is an effective and welltolerated preventive therapy, demonstrating efficacy comparable to or superior to pharmacological treatments with fewer adverse effects. Large-scale, multicentre double-dummy trials remain essential to generate robust evidence to strengthen physicians' confidence in adopting acupuncture as a viable option for migraine management."

Clinical • CNS Disorders • Migraine • Pain

Do we still need non-specific oral prophylaxis for migraine treatment in CGRP-era? Real-life results from an Italian tertiary headache center (EHF-EHC 2025) - "Of the remaining, 354 (56%) received anti-CGRP agents and/or onabotulinumtoxinA injectios; 16 (2.5%) preferred a non-Pharmacological Treatment, and 99 (15.7%) did not need preventive prescription. Among those receiving oral prevention, the drug offered was: tricyclic antidepressants in 52 (31.9%) patients, Beta-blockers in 36 (22.1%), anticonvulsants in 19 (11.7%), Calcium Channel Blockers (flunarizine) in 26 (15.9%), SNRIs in 14 (8.6%), ACEIs/ARBs (candesartan) in 10 (3.7%) and combination of two drugs in 6 (3.7%)... A quarter of migraine patients attending our headache center received non-specific oral preventive. The most frequently prescribed treatments were antidepressants and Beta-blockers. In light of these observations, even in CGRP era, we suggest still an important role of oral conventional prophylaxis in the Headache Center setting."

Clinical • CNS Disorders • Migraine • Pain

Genome-wide meta-analysis with 2,206,440 individuals identifies 322 novel risk loci for obesity. (PubMed, Int J Obes (Lond)) - "We identified 345 genome-wide significant loci, including 322 novel loci for obesity. Based on 345 loci, we provided new biological insights to the etiology of obesity. Of clinical interest, we provided some potential targets and drug repurposing for obesity."

Journal • Retrospective data • Allergy • Ankylosing Spondylitis • Asthma • Cardiovascular • Chronic Obstructive Pulmonary Disease • CNS Disorders • Coronary Artery Disease • Depression • Endocrine Disorders • Genetic Disorders • Hypertension • Immunology • Interstitial Lung Disease • Lung Cancer • Myocardial Infarction • Obesity • Oncology • Psychiatry • Pulmonary Disease • Respiratory Diseases • Seronegative Spondyloarthropathies • Solid Tumor • Spondylarthritis • MC4R

Unraveling Alternating Hemiplegia of Childhood: A Case Report with Genetic and Clinical Insights. (PubMed, Case Rep Neurol) - "Management includes symptomatic treatment and supportive care, with flunarizine offering some benefit. This case highlights the need for early recognition and genetic confirmation of AHC to initiate therapy and improve quality of life."

Journal • CNS Disorders

Impact of Qihuang needle therapy combined with flunarizine hydrochloride for vertigo in vestibular migraine. (PubMed, Neurosciences (Riyadh)) - "This study suggested that QHN combined with FH might had a potential advantage in improving treatment outcomes and reducing short-term recurrence of vertigo in VM patients."

Journal • CNS Disorders • Migraine • Otorhinolaryngology • Pain • Vertigo

Anti-prion drugs reduce endoplasmic reticulum stress and protect human dopaminergic neurons from death. (PubMed, Biomed Pharmacother) - "Notably, several compounds - benzydamine, duloxetine, flunarizine, metixene and triflupromazine - protected LUHMES cells from MPP+ -induced ER stress at nanomolar concentrations. These findings provide the proof of concept that drugs selected for other indications, may be repurposed to ameliorate PD and related pathologies linked to ER stress."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Persistent postural-perceptual dizziness versus vestibular migraine: A narrative review. (PubMed, Headache) - "A multidisciplinary approach addressing both conditions is critical for optimal patient outcomes. Studies on comorbid migraine treatment in patients with PPPD are warranted and may reveal distinct phenotypes within the same disease spectrum."

Journal • Review • CNS Disorders • Migraine • Otorhinolaryngology • Pain • Vertigo

MULTIFACTORIAL ANEMIA IN END-STAGE LIVER DISEASE: A CASE OF ZIEVE SYNDROME AND SPUR CELL ANEMIA (CHEST 2025) - "He developed hepatic encephalopathy, requiring daily Rifaximin and Lactulose...Despite aggressive management with vasopressors, steroids, dobutamine, continuous veno-venous hemofiltration, and bicarbonate infusion, his condition deteriorated...Alternative treatments, including flunarizine, pentoxifylline, and cholestyramine, have shown success in maintaining remission. This case highlights the rapid decompensation in ESLD and the importance of early recognition of conditions like Zieve Syndrome and Spur Cell Anemia. A comprehensive approach, including timely intervention and consideration for liver transplantation, is essential for improving patient outcomes."

Clinical • Acute Respiratory Distress Syndrome • Addiction (Opioid and Alcohol) • Anemia • Cardiovascular • CNS Disorders • Cognitive Disorders • Dyslipidemia • Fibrosis • Hematological Disorders • Hepatic Encephalopathy • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Pneumonia • Portal Hypertension • Pulmonary Disease • Respiratory Diseases • Septic Shock • HP

The nosology of tardive parkinsonism. (PubMed, J Clin Neurosci) - "This proposal has been based on the persistence without progression of a parkinsonian syndrome five years on average following discontinuation of cinnarizine and flunarizine in most of our case series of elderly patients. Whether a permanent non-progressive parkinsonism may occur in elderly patients also following discontinuation of other dopamine receptor antagonists as antipsychotics and benzamide derivatives remains to be established due to lack of comparable prospective follow-up studies. The recognition of TP in elderly patients is important since it has a more favourable long-term prognosis than Parkinson's disease."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Two Cases of SCN4A Temperature-Sensitive Sodium Channelopathy: From Dystonia to Myotonia (MDS Congress 2025) - "Flunarizine provided no benefit, while levodopa showed initial efficacy that diminished over time... These cases highlight the potential misclassification of myotonic channelopathies as expressions of dystonia. The G1306A variant in SCN4A likely creates temperature-sensitive alterations in channel permeability, where exercise-induced metabolic changes and increased body temperature modify channel activity. This pathophysiological mechanism explains the exercise-triggered symptoms and has important therapeutic implications, as treatments for channelopathies differ from those for dystonia."

Clinical • CNS Disorders • Dystonia • Epilepsy • Movement Disorders • NAV1

Phenotypic Spectrum of Movement Disorders in TBC1D24 Gene Variants: A Case Series (MDS Congress 2025) - "2 patients with AHC were started on flunarizine, where 1 had no symptom improvement and adverse effects (musculoskeletal pain, increased tremor) and 1 refused the medication. Patient with focal-segmental myoclonus and epilepsy trialed levetiracetam, valproic acid and clobazam with complete seizure control, and clonazepam was added with moderately improved myoclonus. Patient with PED, PEA and epilepsy trialed levetiracetam, carbamazepine, and oxcarbazepine which worsened symptoms, so acetazolamide was started with significant improvement in symptoms and seizures... This study describes the phenotypic spectrum of movement disorders in 5 pediatric patients with TBCID24 variants. Identified disorders were diverse with varied treatment efficacy. Our findings expand disease understanding and suggest further research need on such emerging variants."

Clinical • Ataxia • CNS Disorders • Epilepsy • Movement Disorders • Musculoskeletal Pain

Drug-induced Parkinsonism Mimicking Parkinson´s Disease in Patients Treated with Flunarizine for Migraine (MDS Congress 2025) - "He was then prescribed with levodopa-carbidopa 125mg...Case 2: 68-year-old female, was prescribed with propranolol 20mg and flunarizine 10mg from our clinic for her frequent migraine episodes and was asked for follow-up in 3 months...Flunarizine was changed to dosulepin 25mg and followed in 2 months with minimal bradykinesia and mask face and resolved tremor. We should be cautious prescribing Flunarizine in elderly people, low-dose treatment, needed proper counselling beforehand regarding the likelyhood of motor adverse effects and regular monitoring of symptoms is needed. Early diagnosis cause reversal of symptoms and reduce the disease and economic burden of patients."

Clinical • CNS Disorders • Migraine • Movement Disorders • Pain • Parkinson's Disease

Expanding the Phenotypic Spectrum of CACNA1A Variants: A Single-Center Experience (MDS Congress 2025) - "Ataxia was treated in 2 patients with acetazolamide and flunarizine, with a partial response. CACNA1A variants show diverse phenotypes, predominantly with movement symptoms. Treatment response varies, highlighting the need for larger studies to better characterize phenotypes and explore treatment options"

Clinical • Ataxia • CNS Disorders • Dystonia • Epilepsy • Migraine • Movement Disorders • Parkinson's Disease • CACNA1A

Efficacy analysis of anti-migraine therapy for acute low-frequency hearing loss and investigation of its mechanisms (PubMed, Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi) - "The standardized group received oral/intravenous steroids + oral/intravenous Ginkgo biloba extract, while the anti-migraine group received postauricular steroid injection/oral steroids + oral flunarizine for 2 weeks...Among the anti-migraine group, 6 patients（21.43%） had a history of ALHL, 13（46.43%） had a confirmed migraine history, 26（92.86%） had anxiety, 26（92.86%） had depression, 5（17.86%） had irritable bowel syndrome, 21（75.00%） had sleep disorders, and 1（3.57%） experienced recurrence within 6 months. Anti-migraine therapy significantly improves the recovery rate in ALHL patients, suggesting that migraine may have a certain correlation with the pathogenesis of acute low-frequency hearing loss."

Clinical • Journal • CNS Disorders • Depression • Gastrointestinal Disorder • Migraine • Mood Disorders • Otorhinolaryngology • Pain • Psychiatry • Sleep Disorder