소아청소년 두통의 예방적 치료로 flunarizine의 효과와 안전성

Abstract

ABSTRACT

The efficacy and safety of flunarizine in treatment of pediatric headache

Joo Min A Advisor : Prof. Rho Young-il, M.D. Ph.D. Department of Medicine, Graduate School of Chosun University

Objectives: To estimate the efficacy and safety of flunarizine in treatment of pediatric headache.

Methods: I 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 prescribed to patients 5 mg daily. The dosage was increased to 10 mg daily when the effectiveness was not. We evaluated frequency, duration, severity, and disability of headache before and after 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, 23 were excluded due to missing records. Finally 62 children were identified: 18 boys and 44 girls with a mean age of 11 years (range 4-19 years). The diagnostic categories were: migraine (27), tension type headache (7), others (28). The mean duration of headache prior to starting flunarizine was 16 months. The mean frequency of attack was 15.1± 8.9 per month. Flunarizine was used for a mean duration of 3.9 months. Starting dose was 5 mg/day. Dose was escalated once in 7 patients because of the unresponsiveness to the initial dose. Maximum dose was 10 mg/day. Good outcome (≤50% reduction in headache frequency) was observed 54.8% (34/62) in 1 month, 70.4% (38/54) in 3 month, 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). Adverse effects lead to discontinuation of flunarizine were seen in 6 including worsening of headache (4), muscle ache (1), and tremor (1). Flunarizine was discontinued due to lack of response in seven patients.

Conclusion: Flunarizine appears to be effective and safe in pediatric headache in our study. In 9.7% of patients, adverse effects lead to discontinuation of flunarizine.