flunarizine / Generic mfg. - LARVOL DELTA

Sibelium exerts anti-migraine effects by remodeling the gut microbiota and regulating metabolic and immune pathways of the brain-gut axis. (PubMed, Int Immunopharmacol) - "Sibelium prevents and attenuates migraines by modulating the microbiota-immune-neural network within the gut-brain axis, providing a novel theoretical foundation for clinical intervention."

Journal • CNS Disorders • Inflammation • Migraine • Pain • FOS • IL1B

Flunarizine attenuates ischemia-reperfusion-induced ovarian injury in rats. (PubMed, J Ovarian Res) - No abstract available

Journal • Preclinical • Cardiovascular • Inflammation • Reperfusion Injury

Treatment Persistence in Migraine Prophylaxis Comparing CGRP Monoclonal Antibodies vs. High-/Low-Evidence Conventional Oral Preventives-A Comparative Real-World Evidence Study of Depersonalized Data of the German Pain e-Registry. (PubMed, J Clin Med) - "Substance-level analysis within HEVP showed the steepest early attrition for tricyclic antidepressants, followed by beta-blockers, with comparatively more favorable though still suboptimal persistence for topiramate and flunarizine. Oral preventives show high discontinuation rates due to both ADR and insufficient efficacy, indicating substantial limitations in real-world applicability. These findings highlight the clinical relevance of a modern mechanism-based migraine prevention with CGRP mAB."

HEOR • Journal • Real-world evidence • CNS Disorders • Migraine • Pain

Antiseizure Medications that Did Not Reach the Epilepsy Market: An Assessment of Factors Contributing to Their Failed Clinical Development Over the Last Three Decades. (PubMed, Drugs) - "Compounds whose development was terminated include atimepazole, beprodone, cannabidivarin, carabersat, conantokin-G, dezinamide, elpetrigine, flunarizine, fluorofelbamate, ICA-105665, isovaleramide, JNJ-40411813, losigamone, naluzotan, padsevonil, pitolisant, ralitoline, remacemide, safinamide, soretolide, talampanel, tonabersat, T2000, T2007, valnoctamide, valrocemide, VX-765, zandatrigine, zuranolone, and 534U87. In some instances, failure to pursue an epilepsy indication could be explained by prioritization of development for other neurological or psychiatric conditions. This may reflect the perception of the drug market for common epilepsies being relatively crowded, and only attractive for compounds with outstanding safety or efficacy advantages over existing medications."

Journal • Review • CNS Disorders • Epilepsy • Psychiatry

An Open Label Pharmacokinetic Study of ASP-001 Formulations in Healthy Volunteers (clinicaltrials.gov) - P1 | N=12 | Not yet recruiting | Sponsor: Aspartes Pharmaceuticals, Inc.

First-in-human • New P1 trial

Blockade of T-type Ca2+ channels disrupts mitochondrial function and follicle development by inhibiting the PI3K/AKT pathway. (PubMed, Reproduction) - "To investigate this, we administered flunarizine (FNZ), a potent T-type VGCCs antagonist, to 4-6-week-old female mice via intraperitoneal injection at doses of 0, 3, or 30 mg/kg/day for 7 days. Furthermore, FNZ inhibit activation of protein kinase B (p-AKT), an effect that was rescued by recilisib, a specific activator of phosphatidylinositol 3-kinase (PI3K)/AKT. In conclusion, our study establishes that pharmacological inhibition of T-type VGCCs disrupts hormonal secretion and follicular development in adolescent mice, likely through modulation of the PI3K/AKT signaling axis."

Journal • Metabolic Disorders

Effects of needle-knife loosening technique on vertigo and vertebrobasilar arterial blood flow in patients with cervical spondylosis of vertebral artery type (PubMed, Zhongguo Zhen Jiu) - "The medication group was treated with oral flunarizine hydrochloride capsules, 10 mg each time, once daily for 12 consecutive days...There were no adverse reactions in both groups. The needle-knife loosening technique could improve vertigo symptoms and balance function in CSA patients and enhance the elasticity and mean blood flow velocity of the vertebrobasilar arteries."

Journal • Otorhinolaryngology • Vertigo

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