Migraine prophylactic therapy: Citalopram versus flunarizine

Objective: Our study is aimed to evaluate to what extent citalopram is efficacious in comparison with flunarizine, in a group of migraine patients. Design: Our study consisted of two phases: 30 days of pharmacological wash-out and 6 months of therapy with monthly followup, during which patients were divided into two groups: Group A: 30 patients (18 women, mean age 36.2, SD 11.2), who received citalopram at a dosage of 20mg/day. Group B: 20 patients (14 women, mean age 33.4, SD 12.8), who received flunarizine at a dosage of 5mg/day. Patients: Between October, 1997, and June, 1998, we examined 50 patients of the Headache Diagnosis and Therapy Service of the Second University of Naples. Thirty-two were women, with an age range of 18 to 65, who suffered from migraine without aura according to IHS criteria.(1) Methods: At the first visit, patients received a careful history, neurological evaluation, and Zung test for depression, revealing no pathological values. In order to monitor symptomatology, all patients received a form for the calculation of the Pain Total index at monthly follow-up. Results: A comparison between standard values and monthly follow-up showed significant reduction (P < 0.05) beginning from the second or third month of treatment in the citalopram group and from the first or second month in the flunarizine group. Conclusion: Although our results are preliminary and need to be confirmed, these data seem to support the use of citalopram in migraine treatment.