Comparing Efficacy of Propranolol Plus Flunarizine Combination and Valproate Monotherapy in Migraine Prophylaxis at a Tertiary Centre in Bihar: a Randomized Control Trial

Background: Migraine is one type of headache, described as a recurring syndrome of headache associated with certain neurological dysfunctions in varying admixtures. It is the second most common cause of headache, and it is the most common headache‐related and indeed neurologic cause of disability in the world, affecting about 15% of women and 6% of men over a period of 1 year. Aims and Objectives: The present study was conducted to assess the efficacy of propranolol plus flunarizine combination and valproate monotherapy in migraine prophylaxis in a tertiary care center. Materials and Methods: The present prospective cross‐sectional study comprised 120 patients with migraine. Out of 120 patients, 24 did not meet the inclusion and exclusion criteria. Hence, 96 patients were enrolled. But six patients were lost to follow‐up. The final analysis was done on 90 patients. Patients were divided into two groups for this clinical study in a prospective parallel group design. 45 patients were included in each group. Group I patients received valproate monotherapy, and Group II patients were on propranolol and flunarizine combination therapy. Results: The study was done on 90 patients with migraine. The mean age of Group I patients was 32.69 ±8.05 (mean SD) years, whereas the mean age of Group II patients was 31.82 ±8.74 (mean±SD) years, respectively. Males were 32 (35.56%) and females were 58 (64.44%). The reduction of headache at baseline was 9.86 with valproate monotherapy and 8.42 with propranolol + flunarizine combination therapy, at the 1st visit it was 6.07 and 5.82, and at the 2nd visit it was 2.81 and 2.19, whereas the reduction in MIDAS score at baseline was 19.50 with valproate monotherapy and 19.6 with propranolol + flunarizine combination therapy, at the 1st visit it was 10.23 and 10.6 and at the 2nd visit it was 5.72 and 5.61 in group I and II, respectively The difference was significant (P < 0.05). Conclusion: In the present study, we found that valproate and propranolol plus flunarizine combinations were both highly effective in migraine prophylaxis. Propranolol plus flunarizine combination therapy was proven to have a better outcome than valproate monotherapy in migraine prophylaxis.