Stubberud A, et al. - Researchers performed this meta-analysis examining the pooled evidence for effectiveness, tolerability, and safety of flunarizine. The data synthesis included 25 studies. Thirty-one out of 175 risk of bias items were scored as “high,” with attrition as the most frequent bias. As per the pooled analysis, reduction in the headache frequency by 0.4 attacks per 4 weeks was evident with flunarizine compared with placebo (5 trials, 249 participants: mean difference (MD) −0.44; 95% confidence interval −0.61 to −0.26). In addition, flunarizine prophylaxis is suggested to have effectiveness comparable to that of propranolol (7 trials, 1151 participants, MD −0.08; 95% confidence interval −0.34 to 0.18). Findings also suggest flunarizine as effective in children. Sedation and weight increase were the most frequent adverse events (AEs) observed. In line with current guideline recommendations, data from partially outdated trials support the effectiveness and well tolerability of 10-mg flunarizine per day in patients with episodic migraine.