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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In recent years a number of new preparations from the group of antiserotonin agents (including cyproheptadine and carbazochrome) as well as beta-adrenergic blocking agents (propranolol) and clonidine have been introduced for prevention of migraine and similar headaches. The efficiency of these drugs was studied in a group of 9 selected cases--adolescents with severe migraine refractory to other methods of treatment. In 7 cases the improvement was noted. The results were compared with own observations on larger groups of adults and data from literature. Too small number of observed patients made impossible definite conclusions. It seems, however that in selected cases the use of these drugs in headaches of adolescents is useful.
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PMID:[New anti-migraine drugs used in the treatment of children and adolescents]. 2 1

Considered from the point of view of clinical practice, the treatment of chronic headache may be either symptomatic and etiological or physiopathological. Progress in symptomatic treatment depends first on the reasonable and graduated use of pure analgesics, looking out for the toxic side effects of the usual drugs and then the fairly definite efficacy of certain psychotropic drugs. The discovery of an etiology gives a specific dimension to the treatment: either anti-cerebral oedema drugs with above all tetracosactide, a diagnostic test of cerebral tumours, or antidepressor or tranquillizer drugs, depending on the variety of disturbance to be corrected. An attack of migraine always benefits from ergotamine used occasionally and in limited dosage (not more than 6 mg daily or 10 mg per week). For the basic treatment the drugs act mainly peripherally and fairly regularly in the following order: methysergide, beta-blockaders, pizotifene, cyproheptadine, oxetorone. Other drugs have a central effect, Tiapridal, MAO inhibitors which are too often neglected, and clonazepam which is not very easy to use.
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PMID:[The present treatment of headaches (author's transl)]. 3 31

Many therapies have been tried in migraines syndroms without completely successful results. So it seems to us interesting to try the efficiency of triapride in this indication. There were 4 observations of patients treated during six months, at least. they all four showed excellent, or very good results. Clinically, headaches of migraine syndroms have been less frequent and less acute; sometimes they have completely disappeared. So, we think that triapride may, in particular migraines, be useful in long term therapy.
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PMID:[Migraines and tiapride. About four observations (author's transl)]. 3 44

In a clinical survey the relation between migraine and menstruation was studied in 142 otherwise healthy women. In 24, onset of migraine coincided with the year of menarch. Of the 138 patients in whom onset of migraine predated the menopause, there were only 13 in whom attacks occurred regularly, and only, just before or during menstruation; in a further 11 attacks occurred regularly in relation to menstruation and at other times. Those with menstrually related migraine were more likely to have onset of migraine at menarche, to have associated weight gain and breast discomfort as part of a periodic syndrome, and to show improvement during pregnancy. There appeared no clear pattern of change at the menopause. In a study of reproductive hormones, blood was collected daily throughout a menstrual cycle from each of 8 women with menstrually related migraine, 6 with menstrually non-related migraine, and 8 healthy headache-free controls. Plasma levels of follicle-stimulating hormone (F.S.H.), luteinising hormone (L.H.), prolactin, oestrogen, and progesterone were measured in all. Plasma-testosterone was measured in 8 migraine patients. Mean plasma oestrogen and progesterone levels were significantly higher in migraine patients than controls for most of the menstrual cycle, with the most striking differences found in the late luteal phase for progesterone. No significant difference was found between the menstrually related and non-related patients for these or the other hormones measured. Mean plasma-prolactin levels were lower in migraine subjects than controls, but the difference was not significant. Mean plasma F.S.H. and L.H. levels were similar in both migraine and control groups. Plasma-testosterone levels were within the range for normal in the 8 migraine patients studied. No specific hormone changes were associated with the occurrence of a migraine attack, nor did rising or falling levels, or greater increments of change over given cycle phases, appear important in provoking attacks.
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PMID:Migraine and reporoductive hormones throughout the menstrual cycle. 4 17

Divided into four groups according to different kind and cause of disorder, 240 patients showing psychosomatic disorders have been treated with chlorazepate dipotassium only or in combination with clomipramine and dihydroergotamine tartrate ambulant or in hospital, depending on the degree of severity of the disorder. With 101 clinically treated cases of cyclothymic depression good results were obtained with combined treatment with chlorazepate dipotassium while reducing the dose of the antidepressant. The same result was obtained with 63 patients suffering from severe neurasthenic exhaustion and 13 patients with general neurodystonic symptoms treated with chlorazepate dipotassium only. The combination of the usual dihydroergotamine tartrate medication with a chlorazepate dipotassium treatment over several months showed longlasting good therapeutic results, confirmed by follow-up examinations, in 31 out of 40 cases with migraine respectively vasomotor headache. In the other nine patients with migraine the complaints persisted only in rare instances.
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PMID:[The role of chlorazepate dipotassium (Tranxilium) in the therapy of psychosomatic syndromes (author's transl)]. 5 67

The mode of action of some classical and newer drugs used in the preventive interval treatment of migraine is discussed in the light of a modern theory of the pathogenesis of migraine headache. This headache is produced when two elements--a passive distension of the extracranial arteries and a lowering of the pain threshold of the receptors situated in the walls of the affected vessels--are present simultaneously. The main humoral factors involved in this phenomenon are plasma-kinins, serotonin and--to a lesser degree--histamine. The role played by serotonin which is released by the blood platelets at the onset of the attack is twofold: on the one hand, free serotonin increases the permeability of the capillaries, favouring transudation of plasmakinins, and lowers the pain threshold, while on the other hand, its increased excretion causes a secondary reduction in its plasma concentration, promoting hypotonicity of the extracranial vessels. Among the substances used for prophylactic interval treatment, some, such as dihydroergotamine, clonidine and the beta-blocking agents have a purely vascular site of action, maintaining--by various mechanisms--the tone of the extracranial arteries and thus reducing their lability. Methysergide and pizotifene have a chiefly indirect effect on the vessels, by potentiating the effect of catecholamines or helping to maintain free serotonin at a certain level. They act primarily against the humoral elements responsible for lowering the pain threshold: methysergide by inhibiting the release and blocking the effects of serotonin, by countering the potentiating effect of serotonin on the pain induced by plasmakinins and by inhibiting histamine release; pizotifene by inhibiting the release and blocking the effects of histamine, by blocking the effects of serotonin and by slightly inhibiting the peripheral effects of plasmakinins. Thus, the multifactorial pathogenesis of migraine helps to explain the effectiveness against migraine of substances possessing the most varied pharmacodynamic profiles.
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PMID:[Mechanism of action of drugs currently used in the prevention of migraine]. 5 25

Forty patients attending the Prince Henry Hospital migraine clinic have been investigated for evidence of complement activation related to migraine. These patients had a history of clinically similar migraine attacks. Levels of serum complement components were determined in nine patients, both in and out of migraine. Comparison of these levels showed significant reductions in C4 and C5 during headache. In a further 31 patients C3 breakdown products were sought when these patients were headache-free. They were detected in the plasma of three patients who proceeded to a migraine attack but not in the plasma of the remaining twenty-eight who did not. These findings suggest the presence of complement activation, which could explain many of the previously reported phenomena associated with migraine.
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PMID:Complement activation in migraine. 6 74

Various parameters of histamine metabolism were studied in patients with migraine, cluster headache and chronic paroxysmal hemicrania. These included urinary excretion of radioactivity and of 14C histamine and its metabolites, exhaled 14CO2 and fecal radioactivity after oral as well as subcutaneous administration of radioactive histamine. No marked deviation from the normal was found except in one patient with the cluster headache variant, chronic paroxysmal hemicrania, in whom an aberration in 14C histamine degradation seemed to be present. Only minute quantities of the 14C histamine metabolite C14 imidazoleacetic acid riboside seemed to be formed during a period with severe paroxysms. During a symptom-free period no deviation from normal was observed. The most likely explanation for this finding seems to be a defect in the conversion of imidazoleacetic acid to its riboside. This defect may possibly explain the increased urinary excretion of histamine in this particular patient. The relationship of this metabolic aberration to the production of headache still remains dubious for various reasons.
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PMID:Histamine metabolism in cluster headache and migraine. Catabolism of 14C histamine. 7

Urinary excretion of histamine, as well as histaminuria following intravenous L-histidine loading, were studied in patients with so-called vascular headache. It was found that urinary excretion of histamine was increased on one or more occasions in 7 of 22 patients with cluster headache. The excretion was significantly higher on attack days than on attack free days. With migraine, increased excretion was found in 5 of 31 patients on days of an attack, whereas the corresponding figure for headache free days was 7 of 24 patients. Three patients showed increased histamine excretion during, as well as between, attacks. The excretion on attack days was not significantly different from that on attack free days. In cluster headache patients, L-histdine administration on attack days did not indicate that an increased histamine formation took place under such circumstances. The underlying mechanism behind the increased histamine output with cluster headache may be increased formation or liberation or altered catabolism. Histamine is more likely to be a consequence than the cause of an attack of cluster headache.
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PMID:Urinary histamine excretion in migraine and cluster headache. Further observations. 7 5

Among 296 patients with thrombocytopenia, 14 had frequent migraine-like headaches, 6 of them having definite migraine. Only 1 of the 6 patients had had migraine before the onset of the blood disorder, and all 6 had migraine attacks during periods of bruising tendency and low platelet count. Control of thrombocytopenia with splenectomy or steroids was accompanied by dramatic improvement in migraine. It is suggested that migraine attacks are caused by abnormal platelet activity and abnormal serotonin metabolism. It is suggested that the immediate factor producing the abnormal platelet activity in our patients was immunological and that other cases of migraine may have an immunological cause.
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PMID:Migraine thrombocytopenia, and serotonin metabolism. 7 65


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