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SYNOPSIS

Experiences gained in this laboratory during long-term, separate prophylactic trials utilizing three different calcium channel blockers among patients with common migraine, classic migraine, mixed and chronic cluster headaches are reviewed. Nifedipine provided symptomatic improvement among 65% of patients with common migraine and among 77% of patients with classic migraine. Forty-one percent of patients with mixed headache reported some relief of head pain. Sixty percent of patients with chronic cluster reported improved control of their headaches. Verapamil produced improved control of symptoms in 81% of patients with common migraine, 72% of those with classic, 67% of those with mixed and 79% of those with cluster. Nimodipine was reported to be beneficial among 84% of patients with common migraine, among 73% of those with classic migraine and among 53% with chronic cluster. Only 33% of patients treated with nimodipine for mixed headache reported improvement. Side effects were more common with nifedipine (71%) than with verapamil (41%) and were least common with nimodipine (20%). Tolerance developed in 42% of those treated with nifedipine and in 49% of those treated with verapamil. Development of tolerance with nimodipine was rare (4%). Each of these three calcium channel blockers showed different and specific therapeutic efficacies which differed according to the clinical classification of the different types of vascular head pain undergoing treatment.