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propranolol chronic migraine

N Karsan, D Palethorpe, W Rattanawong, J C Marin, R Bhola, P J Goadsby
BACKGROUND: For over 20 years, as a group we have been using flunarizine in primary headache disorders. Flunarizine is widely used in Europe, but not licensed in the UK. In September 2014, the National Institute for Clinical Excellence (NICE) published supportive guidelines for flunarizine use in migraine, based on randomised controlled evidence that it is as effective as propranolol and topiramate in adults. METHODS: We reviewed a cohort of adult patients (n=200) treated with flunarizine from our practice...
March 7, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Manel Ben Aissa, Alycia F Tipton, Zachariah Bertels, Ronak Gandhi, Laura S Moye, Madeline Novack, Brian M Bennett, Yueting Wang, Vladislav Litosh, Sue H Lee, Irina N Gaisina, Gregory Rj Thatcher, Amynah A Pradhan
Background Nitric oxide (NO) has been heavily implicated in migraine. Nitroglycerin is a prototypic NO-donor, and triggers migraine in humans. However, nitroglycerin also induces oxidative/nitrosative stress and is a source of peroxynitrite - factors previously linked with migraine etiology. Soluble guanylyl cyclase (sGC) is the high affinity NO receptor in the body, and the aim of this study was to identify the precise role of sGC in acute and chronic migraine. Methods We developed a novel brain-bioavailable sGC stimulator (VL-102), and tested its hyperalgesic properties in mice...
January 1, 2017: Cephalalgia: An International Journal of Headache
Clinton G Lauritsen, Michael J Marmura
Vestibular migraine (VM) is a disorder with a spectrum of clinical presentations and among the most common causes of chronic vestibular symptoms. Some present with attacks before or during typical migraine, but many others have fluctuating or daily symptoms. While the symptoms and pathogenesis of vestibular migraine may have elements of both central and peripheral disorders, hearing loss should be absent. VM typically worsens with activity and head movements in general, and encompasses symptoms of vertigo, disequilibrium, or imbalance...
September 30, 2017: Current Treatment Options in Neurology
Mohsen Ebrahimi-Monfared, Mojtaba Sharafkhah, Ali Abdolrazaghnejad, Abolfazl Mohammadbeigi, Fardin Faraji
BACKGROUND: Melatonin is known to be effective in curing migraine. OBJECTIVE: This study aimed to investigate the therapeutic effect of melatonin versus sodium valproate in the prophylaxis of chronic migraine. METHODS: This randomized, double-blind, placebo-controlled clinical trial included patients with chronic migraine who were divided into three equal sized groups, and baseline therapy with nortriptyline (10-25 mg) and propranolol (20-40 mg) was used...
2017: Restorative Neurology and Neuroscience
Tzu-Chou Huang, Tzu-Hsien Lai, Treatment Guideline Subcommittee Of Taiwan Headache Society Taiwan Headache Society
The Treatment Guideline Subcommittee of the Taiwan Headache Society evaluated the medications currently used for migraine prevention in Taiwan. We assessed the results of new published drug trials, information from medical database and referred to the latest guidelines published. After comprehensive discussion, we proposed Taiwanese consensus about the preventive treatment for migraine including recommendation levels, strength of evidences, and related prescription information regarding dosage and adverse effects...
March 15, 2017: Acta Neurologica Taiwanica
Nelly Boyer, Jérémy Signoret-Genest, Alain Artola, Radhouane Dallel, Lénaïc Monconduit
Migraine is currently conceptualized as a chronic disease with episodic manifestations. In some patients, migraine attack frequency increases, leading to chronic migraine. Daily preventive therapy is initiated to decrease attack frequency. Propranolol, a first-line medication for migraine prophylaxis, reduces attack frequency in nearly 50% of patients receiving it. However, the mechanisms of its antimigraine action are unclear. We examined the effect of daily propranolol treatment (10 mg·kg per os, 8 days) in a rat model of recurrent activation of dural nociceptors (repeated infusion of an inflammatory soup (IS) on the dura through a cannula every 2-3 days)...
July 8, 2017: Pain
Radhouane Dallel, Amélie Descheemaeker, Philippe Luccarini
Background A subgroup of migraineurs experience an increase in attack frequency leading to chronic migraine. Methods We assessed in rats the roles of dose and repeat administration of systemic isosorbide dinitrate (ISDN), a nitric oxide donor, on the occurrence and development of cephalic/face and extracephalic/hindpaw mechanical allodynia as a surrogate of migraine pain, and the effect of acute systemic sumatriptan and olcegepant and chronic systemic propranolol on these behavioral changes. Results A single high (H-ISDN) but not low (L-ISDN) dose of ISDN induces a reversible cephalic and extracephalic mechanical allodynia...
January 1, 2017: Cephalalgia: An International Journal of Headache
Aijie He, Dehua Song, Lei Zhang, Chen Li
BACKGROUND: A large number patients struggle with migraine which is classified as a chronic disorder. The relative efficacy, safety and tolerability of prophylactic medications for migraine play a key role in managing this disease. METHODS: We conducted an extensive literature search for popular prophylactic medications that are used for migraine patients. Pairwise meta-analysis and network meta-analysis (NMA) were carried out sequentially for determining the relative efficacy, safety and tolerability of prophylactic medications...
December 2017: Journal of Headache and Pain
Stephen D Silberstein
BACKGROUND: In evidence-based guidelines published in 2000, topiramate was a third-tier migraine preventive with no scientific evidence of efficacy; recommendation for its use reflected consensus opinion and clinical experience. Its neurostabilizing activity, coupled with its favorable weight profile, made topiramate an attractive alternative to other migraine preventives that caused weight gain. When guidelines for migraine prevention in episodic migraine were published in 2012, topiramate was included as a first-line option based on double-blind, randomized controlled trials involving nearly 3000 patients...
January 2017: Headache
Alycia F Tipton, Igal Tarash, Brenna McGuire, Andrew Charles, Amynah A Pradhan
Background The development of novel migraine therapies has been slow, in part because of the small number of clinically relevant animal models. We have recently developed a new mouse model of chronic migraine using chronic intermittent nitroglycerin, a known human migraine trigger. The objective of this study was to validate this model by testing known and potential migraine-preventive treatments. Methods Migraine therapies were administered to male and female mice for 11 days. On day 3, mice were tested with nitroglycerin every second day for nine days...
October 2016: Cephalalgia: An International Journal of Headache
Mattias Linde, Timothy J Steiner, Dan Chisholm
BACKGROUND: Evidence of the cost and effects of interventions for reducing the global burden of migraine remains scarce. Our objective was to estimate the population-level cost-effectiveness of evidence-based migraine interventions and their contributions towards reducing current burden in low- and middle-income countries. METHODS: Using a standard WHO approach to cost-effectiveness analysis (CHOICE), we modelled core set intervention strategies for migraine, taking account of coverage and efficacy as well as non-adherence...
February 18, 2015: Journal of Headache and Pain
John N Mafi, Samuel T Edwards, Nigel P Pedersen, Roger B Davis, Ellen P McCarthy, Bruce E Landon
BACKGROUND: Headache is a frequent complaint and among the most common reasons for visiting a physician. OBJECTIVE: To characterize trends from 1999 through 2010 in the management of headache. DESIGN: Longitudinal trends analysis. DATA: Nationally representative sample of visits to clinicians for headache from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, excluding visits with "red flags," such as neurologic deficit, cancer, or trauma...
May 2015: Journal of General Internal Medicine
Joseph R Yancey, Richard Sheridan, Kelly G Koren
Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. If a red flag for a secondary cause of headache is present, magnetic resonance imaging of the head should be performed. All patients should be asked about medication overuse, which can increase the frequency of headaches. Patients who overuse medications for abortive therapy for headache should be encouraged to stop the medications entirely and consider prophylactic treatment...
April 15, 2014: American Family Physician
Zsolt Hepp, Lisa M Bloudek, Sepideh F Varon
BACKGROUND: Migraine is a common neurological disease affecting 12% of Americans and millions worldwide. Medication adherence has been studied extensively in many chronic conditions, with poor adherence adversely affecting treatment outcomes. However, little is known about adherence to oral prophylaxis for migraine. OBJECTIVE: To examine the literature on assessing oral prophylaxis medication adherence and persistence among migraine patients. METHODS: A systematic search of the PubMed (1966 to present) and EMBASE (1974 to present) databases was conducted to locate prospective and retrospective observational studies and randomized controlled trials (RCTs) of propranolol, amitriptyline, and topiramate...
January 2014: Journal of Managed Care Pharmacy: JMCP
Lars J Stovner, Mattias Linde, Gøril B Gravdahl, Erling Tronvik, Anne H Aamodt, Trond Sand, Knut Hagen
OBJECTIVE: The objective of this article is to see whether the effect of candesartan for migraine prevention, shown in one previous study, could be confirmed in a new study, and if so, whether the effect was comparable to that of propranolol (non-inferiority analysis), and whether adverse events were different. METHODS: In a randomised, triple-blind, double cross-over study, 72 adult patients with episodic or chronic migraine went through three 12-week treatment periods on either candesartan 16 mg, propranolol slow-release 160 mg, or placebo...
June 2014: Cephalalgia: An International Journal of Headache
Yuka Watanabe, Ryotaro Takashima, Hisatake Iwanami, Shiho Suzuki, Hisaka Igarashi, Koichi Hirata
The Japanese Headache Society and the Japanese Society of Neurology has published the 2013 guidelines for the diagnosis and treatment of chronic headache. A new CQ has been set up in the guidelines on the topic of "How to treat chronic migraine." In the past, lomerizine was the only prophylactic medication of migraine that was eligible under insurance coverage. However, afterward in 2010, valproate was added to the list of antimigraine medications approved under insurance coverage, followed by propranolol, amitriptyline, and verapamil, with rapid advances in the treatment of migraine...
2013: Rinshō Shinkeigaku, Clinical Neurology
Niranjan N Singh, Pradeep Sahota
Sleep and headache have both generated curiosity within the human mind for centuries. The relationship between headache and sleep disorders is very complex. While Lieving in 1873 first observed that headaches were linked to sleep, Dexter and Weitzman in 1970 described the relationship between headache and sleep stages. Though our understanding of sleep and headache relationship has improved over the years with expanding knowledge in both fields and assessment tools such as polysomnography, it is still poorly understood...
December 2013: Current Treatment Options in Neurology
Woranuch Saengcharoen, Sanguan Lerkiatbundit
OBJECTIVES: To describe practice behavior and understanding among pharmacy personnel, both pharmacists and non-pharmacist staff, in the management of mild and moderate migraines. BACKGROUND: Migraine is recognized as a prevalent and chronic neurological disorder. In developing countries, such as Thailand, community pharmacies are a widely used source of health care for various illnesses including migraine. However, the quality of migraine management and knowledge among pharmacy personnel is unclear...
October 2013: Headache
Andrew M Blumenfeld, Lisa M Bloudek, Werner J Becker, Dawn C Buse, Sepideh F Varon, Gregory A Maglinte, Teresa K Wilcox, Ariane K Kawata, Richard B Lipton
OBJECTIVE: Our objective was to characterize patterns of preventive medication use in persons with episodic migraine (EM) and chronic migraine (CM). BACKGROUND: Several classes of medications are used both on- and off-label for the prevention of migraine, including β-blockers (eg, propranolol, timolol), tricyclic antidepressants (eg, amitriptyline), anti-epileptic drugs (eg, topiramate, valproic acid), and neurotoxins (eg, onabotulinumtoxinA). METHODS: Preventive medication use and reasons for discontinuation were collected in an international, Web-based, cross-sectional survey of adults with migraine during 2010...
April 2013: Headache
Khalil El-Chammas, Jill Keyes, Nathan Thompson, Jayanthi Vijayakumar, Dorothy Becher, Jeffrey L Jackson
OBJECTIVE To assess the effectiveness of prophylactic headache treatment in children and adolescents. DATA SOURCES PubMed, EMBASE, Cochrane Database of Clinical Trials, and bibliography of retrieved articles through August 11, 2012. STUDY SELECTION Randomized trials of headache treatment among children and adolescents (<18 years old). INTERVENTION Any placebo-controlled trial or comparisons between 2 or more active medications. MAIN OUTCOME MEASURE Number of headaches per month. RESULTS Among 21 included trials, there were 13 placebo-controlled and 10 active comparator trials (2 also included placebo)...
March 1, 2013: JAMA Pediatrics
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