Subject: A survey to assess the usage pattern of FDC of Propranolol and Flunarizine in the prophylactic treatment of migraine in India
Headache disorders are among the most prevalent neurologic disorders worldwide. Approximately 30% of adults in the age group 18–65 suffer from headache disorders and about 30% of these individuals have migraine. Female-to-male ratio of 3:1 and an estimated 1-year prevalence of approximately 15% in the general population
Oral drugs for migraine prophylaxis include the following therapeutic groups:
Anti- convulsants: topiramate, valproic acid, and gabapentin
Blood pressure medications: Beta/blockers (propranolol)
Anti-depressants: (amitriptyline)
Propranolol is a nonselective beta-adrenergic receptor blocking agent possessing no other autonomic nervous system activity. It specifically competes with beta-adrenergic receptor agonist agents for available receptor sites. When access to beta-receptor sites is blocked by propranolol, the chronotropic, inotropic, and vasodilator responses to beta-adrenergic stimulation are decreased proportionately
The mechanism of the antimigraine effect of propranolol is by reducing the neuronal firing rate of noradrenergic neurons of the locus coeruleus. It inhibits nitric oxide production by blocking inducible nitric oxide synthase (NOS). Propranolol also inhibits kainite-induced currents and is synergistic with N-methylD-aspartate blockers, which reduce neuronal activity and have membrane-stabilizing properties. Beta adrenergic receptors have been demonstrated in the pial vessels of the brain.
Flunarizine is a mixed sodium and calcium channel blocker which prevent calcium from entering cells, resulting in relaxation of heart and vascular smooth muscle, thereby decreasing blood pressure.
Studies have shown Flunarizine to be beneficial as a treatment choice in relation to migraine prophylaxis. Considering its inhibitory effects on the calcium-related contraction of vascular smooth muscle, flunarizine may be a good option for prophylaxis in migraine individuals with cardiovascular diseases such as arrythmias. Additionally, the vestibular depressive effect of this drug was also demonstrated in animals and humans, and recent trials reported the benefit of flunarizine on vestibular symptoms in patients with vestibular migraine.
This survey is conducted to assess the usage pattern of FDC of Propranolol and Flunarizine in the rophylactic treatment of migraine in India
As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of Rs {{$contractAmount}}, on receiving the completed Survey Questionnaire Form from you.
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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