Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Migraine headache is a common condition in women and frequently occurs in relation to the menstrual cycle. This article reviews the neuroendocrine etiology of menstrual migraine, its possible relationship to premenstrual syndrome, and recent developments in treatment strategies for these often refractory headaches.
 ...
PMID:Menstrual migraines: etiology, treatment, and relationship to premenstrual syndrome. 926 97

The pharmacology, pharmacokinetics, efficacy, and adverse effects of dexfenfluramine hydrochloride are reviewed. Dexfenfluramine, the dextrorotatory isomer of fenfluramine, is indicated for use in the management of obesity in patients with a body mass index of > or = 30 kg/m2, or > or = 27 kg/m2 in the presence of other risk factors. Unlike fenfluramine, dexfenfluramine is a pure serotonin agonist. Dexfenfluramine may mimic the effect of carbohydrate intake. Systemic bioavailability is about 68%, and the drug is metabolized in the liver. In randomized, placebo-controlled trials, dexfenfluramine was effective in reducing weight in obese patients given the drug for three or six months. In trials lasting one year, the statistically significant weight loss occurred during months 4 to 6. Dexfenfluramine reduces blood pressure, percent glycosylated hemoglobin, and concentrations of blood glucose and blood lipids, but these benefits may be indirect. Dexfenfluramine may also be of some value in controlling eating habits in diabetic patients, preventing weight gain after smoking cessation, and treating bulimia, seasonal affective disorder, neuroleptic-induced obesity, and premenstrual syndrome. Dexfenfluramine's most frequent adverse effects are insomnia, diarrhea, and headache; it has also been associated with primary pulmonary hypertension. The drug should not be combined with other serotonergic agonists because of the risk of serotonin syndrome. The recommended dosage is 15 mg twice daily. Dexfenfluramine is effective in the treatment of obesity in selected patients. Because its efficacy is lost after six months of continuous treatment, it should be viewed primarily as an adjunct to diet and exercise.
 ...
PMID:Dexfenfluramine hydrochloride: an anorexigenic agent. 937 5

We measured reactivity to a stress paradigm during the premenstrual period in 19 women affected by Menstrually Related Disorders (MRD) and in 11 normal controls. Eight had premenstrual syndrome diagnosed by the Menstrual Distress Questionnaire and 11 suffered menstrual migraine, diagnosed according to International Headache Society criteria. Subjects were observed during two menstrual cycles and submitted to a psychocognitive test (Stroop Color Word) during the luteal phase. In both groups the stimulation by Stroop C-W was present for systolic blood pressure (SBP) (F = 18.14, p = 0.000), diastolic blood pressure (DBP) (F = 9.56, p = 0.000), and heart rate (F = 12.80, p = 0.000). Moreover, an interaction of response by group was present for DBP (2.58, p = 0.04); DBP values were higher in MRD subjects. Also baseline DBP values were higher in MRD with respect to controls. Area under the curve (AUC) subtracted from baseline for the SBP, DBP and heart rate did not differ between groups. In conclusion, MRD subjects facing a cognitive stress had normal cardiovascular response. However, patients had increased arousal of cardiovascular measures before and after testing. The significant differences during stress of testing were dissociated from those of experimental stress stimulation. MRD subjects may have less ability to cope with novelty than healthy volunteers.
Cephalalgia 1997 Dec
PMID:Cardiovascular response to cognitive stress in subjects with menstrually related disorders. 949 69

Pharmacologic intervention is now the most effective therapy available for treating premenstrual syndrome (PMS). Although there are still no Food and Drug Administration-approved medications for this indication, several well-designed studies have been conducted, the results of which may guide the clinician's treatment of women with this disorder. Consequently, less-proven nonpharmacologic modalities, such as dietary modification, exercise regimens, and psychotherapy, are more readily supplanted by the use of medication. Three classes of agents have been shown to have varying degrees of effectiveness in relieving PMS symptoms and are increasingly being used to treat the disorder: gonadotropin-releasing hormone (GnRH) agonists, benzodiazepines, and selective serotonin reuptake inhibitors (SSRIs). While the GnRH agonists like leuprolide acetate, nafarelin acetate, or goserelin acetate have been shown to be highly effective in select cases, their side effects relegate them to use in patients who are unresponsive to other agents. More recently, the benefits of alprazolam (a benzodiazepine) and the SSRIs (especially fluoxetine) have been definitively established. In addition to these medications used to treat premenstrual syndrome in general, other drugs that are used to treat specific aspects of the disorder include danazol for headaches and spironolactone for fluid retention.
 ...
PMID:From GnRH to SSRIs and Beyond: Weighing the Options for Drug Therapy in Premenstrual Syndrome. 974 8

The normal female life cycle is associated with a number of hormonal milestones: menarche, pregnancy, contraceptive use, menopause, and the use of replacement sex hormones. All these events and interventions alter the levels and cycling of sex hormones and may cause a change in the prevalence or intensity of headache. The menstrual cycle is the result of a carefully orchestrated sequence of interactions among the hypothalamus, pituitary, ovary, and endometrium, with the sex hormones acting as modulators and effectors at each level. Estrogen and progestins have potent effects on central serotonergic and opioid neurons, modulating both neuronal activity and receptor density. The primary trigger of menstrual migraine appears to be the withdrawal of estrogen rather than the maintenance of sustained high or low estrogen levels. However, changes in the sustained estrogen levels with pregnancy (increased) and menopause (decreased) appear to affect headaches. Headaches that occur with premenstrual syndrome appear to be centrally generated, involving the inherent rhythm of CNS neurons, including perhaps the serotonergic pain-modulating systems.
 ...
PMID:Sex hormones and headache 1999 (menstrual migraine). 1048 7

The normal female life cycle is associated with a number of hormonal milestones: menarche, pregnancy, contraceptive use, menopause, and the use of replacement sex hormones. All these events and interventions alter the levels and cycling of sex hormones and may cause a change in the prevalence or intensity of headache. The menstrual cycle is the result of a carefully orchestrated sequence of interactions among the hypothalamus, pituitary, ovary, and endometrium, with the sex hormones acting as modulators and effectors at each level. Oestrogen and progestins have potent effects on central serotonergic and opioid neurons, modulating both neuronal activity and receptor density. The primary trigger of menstrual migraine appears to be the withdrawal of oestrogen rather than the maintenance of sustained high or low oestrogen levels. However, changes in the sustained oestrogen levels with pregnancy (increased) and menopause (decreased) appear to affect headaches. Headaches that occur with premenstrual syndrome appear to be centrally generated, involving the inherent rhythm of CNS neurons, including perhaps the serotonergic pain-modulating systems.
Cephalalgia 2000 Apr
PMID:Physiology of the menstrual cycle. 1099 66

PURPOSE: Collecting daily information on a series of similar, recurring events such as menstrual bleeding, headaches, or insulin levels using paper instruments is subject to problems such as missing or incorrectly recorded data, and retrospective data entry. The authors are developing and evaluating electronic data collection using hand-held personal computers (H/PC) for a variety of health-related applications, including tracking premenstrual syndrome (PMS), fertility awareness, and headaches, to improve accuracy and timeliness of data collection.METHODS: ProCycle is a prototype electronic diary for collection of daily data on menstrual bleeding, medications, and health symptoms. In a 3-month pilot test in 25 regularly cycling women, we compared its performance with a paper calendar regarding missing and incorrect data, data entry lag, data cleaning time, and users' preferences with respect to factors such as remembering to enter data, convenience, and overall preference. Additional programs for PMS, fertility, and headaches are being field tested on subjects from the Boston and New York areas, comparing performance with paper versions.RESULTS: In the pilot test, missing data occurred less frequently with ProCycle than with paper, particularly for any days with missing symptoms (4% vs. 35%, p < 0.05). ProCycle did not permit any data recording mistakes such as circling contradictory responses (e.g., bleeding and no bleeding), compared with incorrect data on 13% of paper calendars. Data entry/cleaning time was 81% lower for ProCycle. 70% of users preferred ProCycle overall, compared with 9% preferring paper (p < 0.01).CONCLUSIONS: Although the initial cost of the H/PC is significantly higher than paper, there are no recurring charges for printing or data entry, and data cleaning is minimal. Electronic instruments on an H/PC provide an efficient, accurate method of data collection, applicable to a number of areas of health-related research involving daily data collection.
 ...
PMID:Electronic versus paper instruments for daily data collection. 1101 66

The inclusion of research diagnostic criteria for premenstrual dysphoric disorder (PMDD) in the DSM-IV recognizes the fact that some women have extremely distressing emotional and behavioral symptoms premenstrually. PMDD can be differentiated from premenstrual syndrome (PMS), which presents with milder physical symptoms, headache, and more minor mood changes. In addition, PMDD can be differentiated from premenstrual magnification of physical and/or psychological symptoms of a concurrent psychiatric and/or medical disorder. As many as 75% of women with regular menstrual cycles experience some symptoms of PMS, according to epidemiologic surveys. PMDD is much less common; it affects only 3% to 8% of women in this group. The etiology of PMDD is largely unknown, but the current consensus is that normal ovarian function (rather than hormone imbalance) is the cyclical trigger for PMDD-related biochemical events within the central nervous system and other target organs. The serotonergic system is in close reciprocal relationship with the gonadal hormones and has been identified as the most plausible target for interventions. Thus, beyond the conservative treatment options such as lifestyle and stress management, other nonantidepressant treatments, or the more extreme interventions that eliminate ovulation altogether, the serotonin reuptake inhibitors (SRIs) are emerging as the most effective treatment option for this population. Results from several randomized, placebo-controlled trials in women with PMDD have clearly demonstrated that the SRIs have excellent efficacy and minimal side effects. More recently, several preliminary studies indicate that intermittent (premenstrual only) treatment with selective SRIs is equally effective in these women and, thus, may offer an attractive treatment option for a disorder that is itself intermittent.
 ...
PMID:Premenstrual dysphoria and the serotonin system: pathophysiology and treatment. 1104 80

The inclusion of research diagnostic criteria for premenstrual dysphoric disorder (PMDD) in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, recognizes the fact that some women have extremely distressing emotional and behavioural symptoms premenstrually. PMDD can be differentiated from premenstrual syndrome (PMS), which presents with milder physical symptoms, headache, and more minor mood changes. In addition, PMDD can be differentiated from premenstrual magnification of physical or psychological symptoms of a concurrent psychiatric or medical disorder. As many as 75% of women with regular menstrual cycles experience some symptoms of PMS, according to epidemiologic surveys. PMDD is much less common; it affects only 3% to 8% of women in this group. The etiology of PMDD is largely unknown, but the current consensus is that normal ovarian function (rather than hormone imbalance) is the cyclical trigger for PMDD-related biochemical events within the central nervous system and other target organs. The serotonergic system is in a close reciprocal relation with the gonadal hormones and has been identified as the most plausible target for interventions. Thus, beyond conservative treatment options such as lifestyle and stress management, other non-antidepressant treatments, or the more extreme intervneitons that eliminate ovulation altogether, selective serotonin reuptake inhibitors (SSRIs) are emerging as the most effective treatment option. Results from several randomized, placebo-controlled trials in women with PMDD have clearly demonstrated that SSRIs have excellent efficacy and minimal side effects. More recently, several preliminary studies indicate that intermittent (premenstrual only) treatment with selective SSRIs is equally effective in these women and, thus, may offer an attractive treatment option for a disorder that is itself intermittent.
 ...
PMID:Premenstrual syndrome and premenstrual dysphoric disorder: guidelines for management. 1110 97

The course of migraine without aura (MO) is greatly influenced by the events of female reproductive life. Much less is known about migraine with aura (MA). The aim of this study was to evaluate the relationship between MA and the milestones of reproductive life. A retrospective case control study was carried out on 100 women affected by migraine with typical aura (cases) and 200 age-matched women with MO (controls). Premenstrual syndrome was found to be much more common among the patients with MA (odds ratio (OR) 6.0; confidence interval (CI) 3.1-11.6). Menstrually triggered migraine was more frequently encountered among MO than among MA patients (MA 15.0%; MO 53.5%; OR 0.1; CI 0.1-0.3). In both forms of migraine, pregnancy had a favourable effect; however, a lower percentage of MA (43.6%) than MO patients (76.8%; OR 0.2; CI 0.1-0.5) showed improvement or remission. The use of oral contraceptives worsened migraine in MA more frequently than in MO patients (MA 56.4%; MO 25.3%; OR 3.8; CI 1.6-9.3). The course of MA seems to be influenced by female reproductive life events, but in a different way with respect to MO.
Cephalalgia 2000 Oct
PMID:Migraine with aura and reproductive life events: a case control study. 1116 98


<< Previous 1 2 3 4 5 6 7 Next >>