Title: The Current Status of Treatment among Migraine Patients in Bangladesh
Authors: Dr Mohammad Kamrul Hasan, Prof. Ismail Khan, Dr Tahreema Salam, Dr Methila Sharmin
DOI: https://dx.doi.org/10.18535/jmscr/v7i12.145
Abstract
Objective: In this study our main goal is to evaluate the current status of treatment among migraine patients in Bangladesh.
Methods: This randomized single blind cross over clinical trial was conducted at Department of Pharmacology, Dhaka medical college, Dhaka from July 2015 to June 2016. During the study, adult 64 migraine sufferers (without aura) attending in the Out Patient Department of neurology (Headache clinic), Dhaka Medical College Hospital, Dhaka. All data were recorded systematically in data collection form. One half of the samples were randomly allocated for group A and the other half to group B. Group A: 32 patients will be allocated for the prophylaxis of propranolol. Group B: 32 patients will be allocated for the prophylaxis of flunarizine.
Results: During the study, most common presenting complaints of group A were nausea (81.25%), bothered by light/noise (68.75%), vomiting (56.25%), sparkling, flushing or colored light (37.5), and numbness/ tingling (25%) and in group B were nausea (87.5%), vomiting (65.62%), bothered by light/noise (56.25%), and spakling, flushing or colored lights (43.75%).group A were nausea (81.25%), bothered by light/noise (68.75%), vomiting (56.25%), sparkling, flushing or colored light (37.5), and numbness/tingling (25%) and in group B were nausea (87.5%), vomiting (65.62%), bothered by light/noise (56.25%), and spakling, flushing or colored lights (43.75%).Where prior to second phase of treatment, four weeks were given for wash out for previous medication. Then crossover of treatment was done, i.e group A was assigned flunarizine and group B was assigned propranolol. During baseline the mean HUI score in both the groups were almost the same ( mean scores in group A and group B were 0.33±0.13 and 0.35±0.11 respectively
Conclusion: The present comparative study between propranolol and flunarizine showed that propranolol was more effective for the prophylaxis of migraine without aura. It can be concluded from the study that propranolol should be used as an agent for the prophylaxis of migraine.
Keywords: Flunarizine, migraine, propranolol.
References
- Silberstein SD. Preventive migraine treatment. Neurol Clin. 2009 ;27(2):429-43. PMID: 19289224.
- Lainez MJ, Freitag FG, Pfeil J, et al. Time course of adverse events most commonly associated with topiramate for migraine prevention. Eur J Neurol. 2007;14(8):900-6. PMID: 17662012.
- Luykx J, Mason M, Ferrari MD, et al. Are migraineurs at increased risk of adverse drug responses? A meta-analytic comparison of topiramate-related adverse drug reactions in epilepsy and migraine. Clin Pharmacol Ther. 2009;85(3):283-8. PMID: 18987621.
- Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. 2007;68(5):343-9. PMID: 17261680.
- Olesen J, Bousser MG, Diener HC, et al. New appendix criteria open for a broader concept of chronic migraine. 2006;26(6):742-6. PMID: 16686915.
- S. Food and Drug Administration. FDA News Release: FDA Approves Botox to Treat Chronic Migraine. 2010; www.fda.gov/ NewsEvents/Newsroom/ Press
- Pascual J, El Berdei Y, Gomez-Sanchez How many migraine patients need prolonged (>1 year) preventive treatment? Experience with topiramate. J Headache Pain. 2007;8(2):90-3. PMID: 17221343.
- Goadsby PJ. How do the currently used prophylactic agents work in migraine? Cephalgia. 1997;17(2):85-92
- Solomon GD, Santanello N. Impact of migraine and migraine therapy on productivity and quality of life. 2000;55(9 Suppl 2):29-35. PMID: 11089517.
- Hernandez-Latorre MA, Roig M. Natural history of migraine in childhood. 2000;20(6):573-9. PMID: 11075841.