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Lithium for chronic pain

Todd D Rozen
OBJECTIVE: To describe a second case of treatment refractory chronic cluster headache responsive to clomiphene citrate and with long-term follow-up. METHODS: Case report with 7-year evaluation. CASE: A 63-year-old man with a 17-year history of chronic cluster headache preceded to have significant adverse events or was nonresponsive to multiple cluster headache preventive medications including verapamil, lithium, valproic acid, topiramate, baclofen as well as greater occipital nerve blocks and inpatient hospitalization...
April 2015: Headache
T P Jürgens
Trigeminal autonomic cephalgias (TAC) are characterized by severe and strictly unilateral headaches with a frontotemporal and periorbital preponderance in combination with ipsilateral cranial autonomic symptoms, such as lacrimation, conjunctival injection, rhinorrhea, nasal congestion, and restlessness or agitation. One main differentiating factor is the duration of painful attacks. While attacks typically last 5 s to 10 min in SUNCT syndrome (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing), paroxysmal hemicrania lasts 2-30 min and cluster headaches 15-180 min...
August 2014: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Werner J Becker
Cluster headache pain is very intense, usually increases in intensity very rapidly from onset, and attacks are often frequent. These clinical features result in significant therapeutic challenges. The most effective pharmacological treatment options for acute cluster attack include subcutaneous sumatriptan, 100% oxygen, and intranasal zolmitriptan. Subcutaneous or intramuscular dihydroergotamine and intranasal sumatriptan are additional options. Transitional therapy is applicable mainly for patients with high-frequency (>2 attacks per day) episodic cluster headache, and options include short courses of high-dose oral corticosteroids, dihydroergotamine, and occipital nerve blocks with local anesthetic and steroids...
July 2013: Headache
Haider K Bangash, Tunisia Finch, Vesna Petronic-Rosic, Aisha Sethi, Emily Abramsohn, Stacy Tessler Lindau
BACKGROUND: Nortriptyline and other tricyclic antidepressants are widely used in the treatment of depression. They are also used in chronic pain syndromes such as vulvodynia. We report a case of pityriasis rosea (PR)-like eruption in a young woman who was treated with oral nortriptyline for vulvodynia. CASE REPORT: The patient presented with photosensitivity and erythematous, well-defined, oval papules and patches, with fine collarettes of scale on the dorsal hands, upper arms, and trunk...
April 2013: Journal of Lower Genital Tract Disease
D R Khasanova, Iu V Zhitkova, A A Safiullina, V N Oslopov, N R Khasanov
We studied the correlation between the efficacy of adepress (paroxerine) and the state of cell membranes assessed by the velocity of passive transmembrane ion transport in 39 patients (20 patients with chronic brain ischemia and 19 patients with ischemic stroke). Velocity of passive transmembrane ion transport estimated by the level of Na+-Li+ counter-transport (NLC) in the erythrocyte membrane was a criterion of the cell membrane functional activity. The higher the NLC velocity, the more severe was the course of depression with the development of cognitive dysfunction and pain syndromes in patients with chronic brain ischemia and stroke...
2012: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Peer C Tfelt-Hansen, Rigmor H Jensen
The prevalence of cluster headache is 0.1% and cluster headache is often not diagnosed or misdiagnosed as migraine or sinusitis. In cluster headache there is often a considerable diagnostic delay - an average of 7 years in a population-based survey. Cluster headache is characterized by very severe or severe orbital or periorbital pain with a duration of 15-180 minutes. The cluster headache attacks are accompanied by characteristic associated unilateral symptoms such as tearing, nasal congestion and/or rhinorrhoea, eyelid oedema, miosis and/or ptosis...
July 1, 2012: CNS Drugs
M L Yang, J J Li, K F So, J Y H Chen, W S Cheng, J Wu, Z M Wang, F Gao, W Young
STUDY DESIGN: Lithium has attracted much attention as a neuroregenerative agent for spinal cord injury in animal models. We hypothesized that the lithium can be beneficial to patients with spinal cord injury. The safety and pharmacokinetics of lithium has been studied in our earlier phase I clinical trial, indicating its safety. This is a phase II clinical trial to evaluate its efficacy on chronic spinal cord injury patients. OBJECTIVES: The aim of this study was to investigate the efficacy of lithium on chronic spinal cord injury patients...
February 2012: Spinal Cord
Ping-Kun Chen, Hsi-Ming Chen, Wei-Hung Chen, Yeng-Yu Chen, Jong-Ling Fuh, Lian-Hui Lee, Yi-Chu Liao, Kao-Chang Lin, Hung-Ping Tseng, Jing-Jane Tsai, Po-Jen Wang, Shuu-Jiun Wang, Chun-Pai Yang, Chun-Hing Yiu, Zin-An Wu
The Treatment Guideline Subcommittee of the Taiwan Headache Society evaluated both the acute and the preventive treatments for cluster headache now being used in Taiwan, based on the principles of evidence- based medicine. We assessed the quality of clinical trials and levels of evidence, and referred to other treatment guidelines proposed by other countries. Throughout several panel discussions, we merged opinions from the subcommittee members and proposed a consensus on the major roles, recommended levels, clinical efficacy, adverse events and cautions of clinical practice regarding acute and preventive treatments of cluster headache...
September 2011: Acta Neurologica Taiwanica
Charly Gaul, Hans-Christoph Diener, Oliver M Müller
BACKGROUND: Cluster headache is the most common type of trigemino-autonomic headache, affecting ca. 120 000 persons in Germany alone. The attacks of pain are in the periorbital area on one side, last 90 minutes on average, and are accompanied by trigemino-autonomic manifestations and restlessness. Most patients have episodic cluster headache; about 15% have chronic cluster headache, with greater impairment of their quality of life. The attacks often possess a circadian and seasonal rhythm...
August 2011: Deutsches Ärzteblatt International
Marco A Arruda, Lucas Bonamico, Cleiber Stella, Carlos A Bordini, Marcelo E Bigal
BACKGROUND: Cluster headache (CH) is a rare cause of headache in children. Onset before 12 years of age is unusual, and long-term follow-up of pediatric cases has been not reported. OBJECTIVES: To report three cases of CH with onset at childhood and at least ten years of follow-up. METHODS: Case report. RESULTS: The first case is that of a 12-year-old boy with episodic CH with unilateral pain and striking, bilateral autonomic manifestations, remitted for over eight years...
October 2011: Cephalalgia: An International Journal of Headache
Avi Ashkenazi, Todd Schwedt
Cluster headache (CH) pain is the most severe of the primary headache syndromes. It is characterized by periodic attacks of strictly unilateral pain associated with ipsilateral cranial autonomic symptoms. The majority of patients have episodic CH, with cluster periods that typically occur in a circannual rhythm, while 10% suffer from the chronic form, with no significant remissions between cluster periods. Sumatriptan injection or oxygen inhalation is the first-line therapy for acute CH attacks, with the majority of patients responding to either treatment...
February 2011: Headache
Massimo Leone, Angelo Franzini, Alberto Proietti Cecchini, Eliana Mea, Giovanni Broggi, Gennaro Bussone
Primary cluster headache (CH) is an excruciatingly severe pain condition. Several pharmacologic agents are available to treat chronic CH, but few double-blind, randomized clinical trials have been conducted on these agents in recent years, and the quality of the evidence supporting their use is often low, particularly for preventive agents. We recommend sumatriptan or oxygen to abort ongoing headaches; the evidence available to support their use is good (Class I). Ergotamine also appears to be an effective abortive agent, on the basis of experience rather than trials...
February 2011: Current Treatment Options in Neurology
B K Y Wong, S M Hossain, E Trinh, G A Ottmann, S Budaghzadeh, Q Y Zheng, E M Simpson
The NR2E1 region on Chromosome 6q21-22 has been repeatedly linked to bipolar disorder (BP) and NR2E1 has been associated with BP, and more specifically bipolar I disorder (BPI). In addition, patient sequencing has shown an enrichment of rare candidate-regulatory variants. Interestingly, mice carrying either spontaneous (Nr2e1(frc) ) or targeted (Tlx(-) ) deletions of Nr2e1 (here collectively known as Nr2e1-null) show similar neurological and behavioral anomalies, including hypoplasia of the cerebrum, reduced neural stem cell proliferation, extreme aggression and deficits in fear conditioning; these are the traits that have been observed in some patients with BP...
October 2010: Genes, Brain, and Behavior
Rashmi Halker, Bert Vargas, David W Dodick
Cluster headache is a rare yet exquisitely painful primary headache disorder occurring in either episodic or chronic patterns. The unique feature of cluster headache is the distinctive circadian and circannual periodicity in the episodic forms. The attacks are stereotypic--they are of extreme intensity and short duration, occur unilaterally, and are associated with robust signs and symptoms of autonomic dysfunction. Although the pathophysiology of cluster headache remains to be fully understood, there have been a number of recent seminal observations...
April 2010: Seminars in Neurology
Colleen E Kovacsics, Todd D Gould
Aggression is associated with numerous psychiatric disorders. Evidence suggests that lithium decreases aggression in humans and rats. The effects of lithium on aggression related behavior, and in particular shock-induced aggression, has not been as thoroughly explored in mice. Male mice were treated with lithium and tested in the shock-induced aggression and dominance tube tests. Mice treated with lithium were also assessed for thermal pain and shock sensitivity in the hot plate and jump-flinch tests. In the shock-induced aggression paradigm chronic lithium significantly decreased both the frequency and duration of attacks, without affecting social interaction or behavior in the dominance tube...
January 2010: Pharmacology, Biochemistry, and Behavior
Hosein Shamshiri, Pedram Paragomi, Mehrak Javadi Paydar, Leila Moezi, Moslem Bahadori, Behnaz Behfar, Farid A Ardalan, Ahmad R Dehpour
BACKGROUND AND AIM: Lithium, a widely used drug in bipolar-affective disorders, plays gastro-protective roles. The effects of lithium on several tissues are mediated through nitric oxide (NO), which regulates gastrointestinal motility and mucosal integrity. The aim of this study was to investigate the protective effect of chronic lithium administration on visceral hypersensitivity and to investigate the role of NO as a potential mechanism of lithium in a rat model of irritable bowel syndrome...
April 2009: Journal of Gastroenterology and Hepatology
Elizabeth Leroux, Anne Ducros
Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year...
2008: Orphanet Journal of Rare Diseases
Elliot V Hersh, Andres Pinto, Paul A Moore
BACKGROUND: Eight analgesic preparations with approved indications for acute pain were among the top 200 drugs prescribed in the United States in 2006. In addition, an estimated 36 million Americans use over-the-counter (OTC) analgesics daily. Given this volume of use, it is not surprising that a number of drug interactions involving analgesic drugs have been reported. OBJECTIVES: This article examines the pharmacologic factors that enhance the clinical relevance of potential drug interactions and reviews the literature on drug interactions involving the most commonly used analgesic preparations in the United States...
2007: Clinical Therapeutics
D Valade
Cluster headache is a primary headache with a male predominance that presents in two forms: episodic and chronic, occurring at 45-to 60-day intervals with one to three headaches a day lasting 45 min to 2 h. An attack starts by a violent unilateral retro-ocular pain with sympathetic signs such as tearing and rhinorrhea. Diagnosis is made by questioning and therefore requires no complementary tests. Treatment for the attack consists of injectable sumatriptan or oxygen therapy, with long-term treatment with verapamil, lithium salts, or Topiramate; in certain cases in which the number of attacks is greater than two, injections of corticosteroids at the emergence of the Arnold nerve can be used, or in cases of attacks resistant to all treatments, hypothalamus stimulation surgery can be useful...
October 2007: Annales D'oto-laryngologie et de Chirurgie Cervico Faciale
Shearwood McClelland, Rahul D Tendulkar, Gene H Barnett, Gennady Neyman, John H Suh
OBJECTIVE: Medically refractory cluster headache (CH) is a debilitating condition for which few surgical modalities have proven effective. Previous reports involving short-term follow-up of CH patients have reported modest degrees of pain relief after radiosurgery of the trigeminal nerve ipsilateral to symptom onset. With the recent success of deep brain stimulation as a surgical modality for these patients, it becomes imperative for the long-term risks and benefits of radiosurgery to be more extensively delineated...
December 2006: Neurosurgery
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