Flunarizine as add-on therapy in refractory epilepsy: An open trial

We evaluated flunarizine as add-on therapy for control of refractory epilepsy in an open trial in 17 patients. Children received 10 mg/day and adults received 20 mg/day of flunarizine for 6 months. In eight patients, antiepileptic drug (AED) serum levels at baseline and at 3 months of flunarizine therapy were available. Six of the 17 patients had seizure reduction greater than or equal to 50%. Three of six had generalized tonic-clonic seizures (GTCS). Most of remaining patients were unchanged or had increased complex partial seizures (CPS). Three of the six patients with greater than or equal to 50% seizure reduction were treated with phenobarbital (PB) and phenytoin (PHT) combination. Addition of flunarizine caused no significant alteration in baseline serum AED levels. With the addition of flunarizine, seizure control in patients with GTCS was better than that of patients with CPS. Patients receiving combination PB and PHT treatment responded better with the addition of flunarizine than did those receiving other AED combinations. We conclude that flunarizine had some antiepileptic property as add-on therapy in 35% of our cases with refractory epilepsy.