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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
Daniel Mines, Patricia Tennis, Suellen M Curkendall, De-Kun Li, Craig Peterson, Elizabeth B Andrews, Brian Calingaert, Hong Chen, Gaurav Deshpande, Daina B Esposito, Nicholas Everage, Crystal N Holick, Nicole M Meyer, Ella T Nkhoma, Sherry Quinn, Kenneth J Rothman, K Arnold Chan
PURPOSE: First marketed in the USA in 1996, topiramate (TPM) is an antiepileptic drug later approved for migraine prophylaxis, and in 2012 for weight loss in combination with phentermine. Some studies indicate an elevated prevalence of oral cleft (OC) in infants exposed to TPM in utero. We evaluated the association between TPM use in early pregnancy and the risk of OC. METHODS: This retrospective cohort study used 1997-2011 automated data from four sources: HealthCore and OptumInsight (commercial insurance claims), Truven Health (Medicaid claims), and Kaiser Permanente Northern California Region (electronic medical records)...
October 2014: Pharmacoepidemiology and Drug Safety
Stephen A Contag, Cheryl Bushnell
PURPOSE OF REVIEW: Migraine is a frequent event among women of reproductive age. It is difficult to predict the course and severity of disease that migraineurs will endure during pregnancy. Treatment is often compromised during pregnancy because of concerns regarding pharmacotherapy and fetal well being. RECENT FINDINGS: The majority of women with migraine during pregnancy will not require ongoing pharmacotherapy or prophylaxis. Nonpharmacologic strategies should be the first-line treatment of migraines...
December 2010: Current Opinion in Obstetrics & Gynecology
Michael J Marmura, Stephen D Silberstein, Todd J Schwedt
The study aims to provide an updated assessment of the evidence for individual pharmacological therapies for acute migraine treatment. Pharmacological therapy is frequently required for acutely treating migraine attacks. The American Academy of Neurology Guidelines published in 2000 summarized the available evidence relating to the efficacy of acute migraine medications. This review, conducted by the members of the Guidelines Section of the American Headache Society, is an updated assessment of evidence for the migraine acute medications...
January 2015: Headache
Anne W Hauge, Mohammed S Asghar, Henrik W Schytz, Karl Christensen, Jes Olesen
BACKGROUND: Migraine with aura is thought likely to be caused by cortical spreading depression (CSD). Tonabersat inhibits CSD, and we therefore investigated whether tonabersat has a preventive effect in migraine with aura. METHODS: In this randomised, double-blind, placebo-controlled crossover trial, 40 mg tonabersat once daily was compared with matched placebo in patients who had at least one aura attack per month during the past 3 months. Randomisation was by computer-generated list...
August 2009: Lancet Neurology
Paul Winner, Eric M Pearlman, Stephen L Linder, Donna M Jordan, Alan C Fisher, Joseph Hulihan
OBJECTIVE: To assess the efficacy and safety of topiramate for the prevention of pediatric migraine with or without aura in a double-blind, randomized, placebo-controlled trial. BACKGROUND: Treatment options for pediatric migraine are currently limited, and no migraine preventive agents are approved for use in children in the United States. Topiramate is an effective migraine preventive therapy in adults, as demonstrated in several large, randomized, placebo-controlled trials...
November 2005: Headache
Mihaela-Bianca Anoaica, P G Anoaica, Florica Popescu
In a retrospective study we evaluated the efficacy and tolerability of Acetylsalicylic Acid (ASA), an antiplatelet drug, in the prophylactic treatment of migraine with aura (MA). We reviewed the charts of 203 patients suffering from MA according to the ICHD II criteria, attending to Turin University Headache Centre. 95 subjects (46.8%) were treated with ASA at low dose, 108 (53.2%) with other prophylactic therapies normally used for migraine for a period that ranged from at least 4 months to 194 months. Eighty-four patients (88...
April 2014: Current Health Sciences Journal
Munvar Miya Shaik, Siew Hua Gan
Migraine is the most common form of headache disorder globally. The etiology of migraine is multifactorial, with genetic components and environmental interactions considered to be the main causal factors. Some researchers postulate that deficits in mitochondrial energy reserves can cause migraine or an increase in homocysteine levels can lead to migraine attacks; therefore, vitamins could play a vital role in migraine prevention. For instance, riboflavin influences mitochondrial dysfunction and prevents migraine...
2015: BioMed Research International
C Lampl, Z Katsarava, H-C Diener, V Limmroth
This study examined the efficacy of lamotrigine in the prevention of migraine aura. Fifty nine patients suffering from migraine with aura received lamotrigine in a controlled three year prospective open study. Treatment response was defined as a reduction of aura frequency each month by at least 50%. Primary endpoint was reached by three quarters of the patients. Lamotrigine significantly reduced both frequency of migraine aura (mean, 1.5 (SD, 0.6) each month before v 0.4 (0.7) after treatment; p < 0.001) and aura duration (mean, 27 (SD, 11) minutes before v 8 (14) after treatment; p < 0...
December 2005: Journal of Neurology, Neurosurgery, and Psychiatry
Benjamin W Friedman
No abstract text is available yet for this article.
August 7, 2016: Annals of Emergency Medicine
Alex J Sinclair, Aaron Sturrock, Brendan Davies, Manjit Matharu
Headache is one of the most common conditions presenting to the neurology clinic, yet a significant proportion of these patients are unsatisfied by their clinic experience. Headache can be extremely disabling; effective treatment is not only essential for patients but is rewarding for the physician. In this first of two parts review of headache, we provide an overview of headache management, emerging therapeutic strategies and an accessible interpretation of clinical guidelines to assist the busy neurologist...
December 2015: Practical Neurology
Jakob Møller Hansen, Peter J Goadsby, Andrew Charles
OBJECTIVE: To determine whether acute migraine treatment outcome is different in migraine with aura compared with migraine without aura. METHODS: We examined pooled outcome data for sumatriptan treatment of migraine with and without aura from the sumatriptan/naratriptan aggregate patient database. We also examined similar outcome data for inhaled dihydroergotamine (DHE) from a single, large randomized controlled study. RESULTS: The pooled pain-free rates 2 hours postdose for sumatriptan 100 mg were significantly higher in patients treating attacks without aura (32%) compared with the group who treated attacks with aura (24%) (p < 0...
May 5, 2015: Neurology
Frank Seifert
No abstract text is available yet for this article.
July 2015: Pain
Todd D Rozen
OBJECTIVE: To assess the efficacy of melatonin as a preventive therapy for hemicrania continua in a larger population of patients than has previously been studied. BACKGROUND: Hemicrania continua is defined by its sensitivity to indomethacin. Rarely can patients be fully tapered off indomethacin without headache recurrence; thus, the risks associated with chronic indomethacin usage are substantial for these individuals. Melatonin, a pineal hormone with a similar chemical structure to indomethacin, has shown efficacy as a preventive agent for hemicrania continua in isolated case reports...
March 2015: Headache
János Tajti, Zsófia Majláth, Délia Szok, Anett Csáti, László Vécsei
INTRODUCTION: A number of drugs are available for acute migraine treatment, but they are not all effective for all patients and all attacks. The safety profiles of migraine drugs limit their use in patients with certain comorbid conditions, and adverse effects may also reduce the level of patient compliance. AREAS COVERED: The different types of acute migraine drugs are discussed, with particular regard to safety issues and potential adverse effects. The frequent use of analgesics, ergot alkaloids and triptans may result in the development of medication overuse headache (MOH)...
June 2015: Expert Opinion on Drug Safety
Usha K Misra, Jayantee Kalita, Sanjeev K Bhoi
Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for pain but there is no class 1 study on its role in migraine prophylaxis. In this study we report the efficacy and safety of high-rate rTMS in migraine prophylaxis. Adult migraine patients having >4 attacks/month were randomized to high-rate rTMS or sham stimulation. Stimulation in the form of 10 Hz rTMS, 600 pulses in 10 trains were delivered to the hot spot of the right abductor digiti minimi in 412 s. Three sessions were delivered on alternate days...
November 2013: Journal of Neurology
Joel R Saper, Alvin E Lake, Deborah T Cantrell, Paul K Winner, Jeffery R White
OBJECTIVE: To assess the efficacy of tizanidine hydrochloride versus placebo as adjunctive prophylactic therapy for chronic daily headache (chronic migraine, migrainous headache, or tension-type headache). BACKGROUND: Tizanidine is an alpha2-adrenergic agonist that inhibits the release of norepinephrine at both the spinal cord and brain, with antinociceptive effects that are independent of the endogenous opioid system. Previous open-label studies have suggested the drug may be effective for treatment of chronic daily headache...
June 2002: Headache
Tamara Pringsheim, W Jeptha Davenport, Gordon Mackie, Irene Worthington, Michel Aubé, Suzanne N Christie, Jonathan Gladstone, Werner J Becker
OBJECTIVES: The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month). METHODS: Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified...
March 2012: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Mahmoud Reza Ashrafi, Soodeh Salehi, Reza Azizi Malamiri, Morteza Heidari, Seyed Ahmad Hosseini, Mahboubeh Samiei, Ali Reza Tavasoli, Mansoureh Togha
BACKGROUND: In spite of the high occurrence of migraine headaches in school-age children, there are currently no approved and widely accepted pharmacologic agents for migraine prophylaxis in children. Our previous open-label study in children revealed the efficacy of cinnarizine, a calcium channel blocker, in migraine prophylaxis. A placebo-controlled trial was conducted to demonstrate the efficacy and safety of cinnarizine in the prophylaxis of migraine in children. TRIAL DESIGN: A double-blind, placebo-controlled, parallel-group study conducted in a tertiary medical center in Tehran, Iran...
October 2014: Pediatric Neurology
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