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

We conducted pharmacodynamic studies with a new vasodilator, MDL-899. Following initial dose-ranging studies we studied eight male normotensive volunteers, each of whom received, orally, 10 mg MDL-899 or placebo in double-blind random order. MDL-899 significantly lowered standing blood pressure, the maximal effect occurring 3-6 h following drug administration. There was a significant increase in heart rate in both supine and standing positions, maximal 6-8 h postdose. Supine plasma noradrenaline concentrations were greater following MDL-899, with the greatest difference present 4 h after drug administration. Plasma renin concentrations were greater following MDL-899. Six of our subjects were also given 10 mg MDL-899 together with 100 mg atenolol, in an additional study. Atenolol increased the hypotensive effect and attenuated the tachycardia following MDL-899 alone. Side effects following MDL-899 administration included headache, lightheadedness, and tachycardia. These were reduced following atenolol coadministration. The haemodynamic profile of MDL-899 suggests that this drug acts as a direct arteriolar vasodilator in man. The observed increase in heart rate is likely mediated by reflex activation of the sympathetic nervous system.
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PMID:Pharmacodynamic studies in normal volunteers with MDL-899, a new arteriolar vasodilator. 619 50

Zimeldine, imipramine and placebo were studied in a randomized, double-blind, parallel group comparison of 119 patients with primary affective disorders. These out-patients were between 18 and 65 years of age and all received placebo single-blind during an initial 3-7-day washout period. During the subsequent 6-week double-blind period, patients were titrated from 50 mg b.d. to 150 mg b.d. with zimeldine, a potent and selective inhibitor of 5-HT reuptake, with imipramine, an inhibitor of noradrenaline and 5-HT reuptake, or with a corresponding number of placebo capsules. The zimeldine treatment group had significantly lower mean HAM-D scale total scores than the placebo and imipramine groups at week 4 and last available assessment. There was a significantly greater proportion of patients showing an improvement of 50% or more in HAM-D score, among the zimeldine group than in the placebo group at week 4, and among the imipramine group at weeks 4, 6 and last available assessment. The Clinical Global Impression (CGI) scales and the 56-item Hopkins Symptom Check-list (HSCL-56) self-rating inventory both showed significantly more improvement in the zimeldine patients than in the placebo or the imipramine patients. Fewer zimeldine patients reported adverse experiences than imipramine patients. Dry mouth was the most frequently reported adverse experience, occurring significantly more often in the imipramine group than the zimeldine or the placebo groups; significantly more zimeldine than placebo patients reported dry mouth. Headache was the only other adverse experience which occurred more often in the zimeldine than in the placebo group. The imipramine group had consistently higher mean pulse rates than the other two groups, and postural hypotension was also more common in the imipramine group.
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PMID:A double-blind, controlled evaluation of zimeldine, imipramine and placebo in patients with primary affective disorders. 623 Aug 97

Plasma levels of adrenaline, noradrenaline, cAMP, free fatty acids and serum DBH, were estimated in a group of ten migrainous patients before, during and after a migraine attack. All parameters, apart from adrenaline, showed a statistically significant elevation during the headache period. As the blood concentration of the above substances taken in combination is the most reliable index of sympathetic activity available at present, these findings indicate that there is considerable sympathetic dysfunction during the migraine attack.
Cephalalgia 1981 Jun
PMID:Biochemical indices of sympathetic activity in migraine. 628 34

A pupillometric study was performed to evaluate the mydriatic response to tyramine, a noradrenaline releaser. There were three groups of subjects: (a) 10 cluster headache patients, in an asymptomatic period; (b) 20 of their close relatives, exempt from this disease; (c) 10 healthy controls. The tyramine was instilled into both eyes of each subject. The controls displayed an isocoric tyramine-induced mydriasis but the cluster headache sufferers and their relatives showed an anisocoric mydriasis. This anisocoric mydriasis was caused by a deficient mydriatic response on one side, which in the cluster patients corresponded to the symptomatic side. The sympathetic abnormality of the iris may be the expression of a functional asymmetry in the hypothalamus. Central sympathetic asymmetry could thus represent a dysgenetic family predisposition to lateralized headache attacks.
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PMID:Asymmetric mydriatic response to topical tyramine in cluster headache relatives. 649 Feb 43

Alpha-adrenergic mechanisms have frequently been implied in migraine pathophysiology. We have examined the noradrenaline reactivity of isolated human temporal arteries removed from six migraine sufferers (not during attack) and from six patients without migraine operated for intracranial disorders. Noradrenaline constricted these vessels in a concentration-dependent manner, the response being altered by phentolamine 10(-8) M to 10(-6) M. There was no statistically significant difference between migraine patients and controls with respect to maximal contractile force (Emax) or pD2 (negative logarithm of the concentration eliciting half maximal force). The pA2 value for phentolamine was 8.3 in vessels from controls and 7.6 in arteries from migraine sufferers. The small difference between migraine patients and controls was not statistically significant. We obtained clear evidence of alpha-adrenergic receptors in human temporal arteries but their sensitivity was independent of the migraine disorder.
Cephalalgia 1983 Dec
PMID:Presence of alpha-adrenoceptors in human temporal arteries. Comparison between migraine patients and controls. 664 Jun 54

A 29-year-old female who had undergone resection of an abdominal paraaortic pheochromocytoma weighing 33 g at the age of 20 had had severe headaches, hypertension and hyperhidrosis 3 years prior to the surgery. Postoperatively, her symptoms completely disappeared and urinary catecholamines were normalized. She was well and had married and had had 2 children. She was admitted to our hospital on August 22, 1982, for further evaluation of hypertension (154/100), which had been diagnosed 2 months previously. Endocrinological studies confirming the presence of a pheochromocytoma were as follows: 1) Plasma noradrenaline level was significantly elevated to 1750 pg/ml. 2) Urinary catecholamine and their metabolites (Metanephrines and VMA) were markedly elevated. Her blood pressure was borderline hypertension and its diurnal rhythm was lost. Her blood pressure decreased to normal values after the oral administration of labetalol (100 mg). Plasma noradrenaline level was still high at 180 minutes after the oral administration of clonidine (150 micrograms). Hypertensive response to insulin-induced hypoglycemia (regular insulin 0.1 u/kg i.v.) was observed, but blood pressure returned to normal after the infusion of glucose alone. Hypertensive response to both metoclopramide (5 mg i.v.) and sulpiride (50 mg per os) was observed accompanying the significant elevation of plasma noradrenaline. Computed tomography and ultrasonography revealed a tumor localized between the aorta and the vena cava inferior. Selective venous sampling also revealed an intrathoracic pheochromocytoma. On October 8, 1982, a 28 g mass was removed from the mediastinum just above the diaphragma. Histologically, it was typical of a pheochromocytoma. Electron microscopy showed large polygonal cells with numerous large secretory granules characteristic of noradrenaline-granules. Postoperative blood pressure was normal, but repeated measurements of plasma and urinary catecholamines were still slightly high. We, therefore, followed her case carefully at our out-patient clinic. In order to clarify the mechanism of catecholamine release by metoclopramide and sulpiride, tissue cultures of removed pheochromocytoma with and without these drugs were carried out. The in vitro studies revealed that metoclopramide released noradrenaline eight-fold and sulpiride 13-fold as compared with noradrenaline in a control medium. We concluded that both drugs stimulated catecholamine secretion directly from the tumor and thus, careless administration of these drugs should be avoided when pheochromocytoma was suspected, large or small. Finally, the rate of tumor growth seemed to be very slow because it took 9 years to ach
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PMID:[Case of intrathoracic pheochromocytoma occurring 9 years after resection of intraabdominal paraaortic pheochromocytoma: effect of metoclopramide and sulpiride on catecholamine secretion in vitro]. 666 41

Sixteen patients with a headache resembling the so-called "tension headache" and a clear response to doxepin (demonstrated in a previous work) were given femoxetine, 400 mg p.d., and placebo in a cross-over, double-blind fashion. Only single blindness was kept in the last third of the study. Placebo and femoxetine tablets were each given for four weeks. Whereas there was a daily or practically daily occurring headache untreated, placebo was associated with a headache frequency of 92%. The corresponding figures for doxepin and femoxetine were 27% and 41%, respectively. Femoxetine led to transitory nausea and gastrointestinal discomfort, but in contrast to doxepin, no weight gain and only slight, if any, sedation. Most patients preferred femoxetine to doxepin. Femoxetine, an antidepressant phenylpiperidine derivative with predominant serotonin re-uptake inhibition (little effect on noradrenaline), thus seems to counteract so-called "tension headache".
Cephalalgia 1983 Mar
PMID:So-called "tension headache"--the response to a 5-HT uptake inhibitor: femoxetine. 685 Aug 22

Sixteen patients with tension headaches were treated with acupuncture, needles being inserted in the hand and foot and then electrostimulated. All patients were seen at four 2-h sessions with intervals of 1 week between each. The first two sessions were used for clinical examination only, thus serving as control, while acupuncture was administered during the last two sessions. Urine samples were collected immediately before and after each session and later analyzed for catecholamine content. During the 1-week intervals between sessions, records were kept of headache attacks and medicine intake. Following acupuncture two-thirds of the patients showed reduction in number of headache attacks, and about one half of the patients reduced their use of pain relieving drugs considerably. Urinary excretion of adrenaline and noradrenaline was always higher in samples collected before sessions than after sessions. However, this reduction in catecholamine excretion was significantly greater when acupuncture had been administered.
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PMID:Effect of acupuncture on tension headache and urinary catecholamine excretion. 696 Apr 69

1. Guanfacine (2-6 mg/day) a centrally acting antihypertensive drug, was effective in controlling blood pressure in 5 essential hypertensives and lowered plasma noradrenaline and urinary catecholamine excretion. 2. Withdrawal of guanfacine by blind substitution of identical placebo tablets under observation in hospital led to a gradual recovery of blood pressure over 2-4 days. 3. Salivary flow, which was reduced on guanfacine, returned to pretreatment levels by 2 days after withdrawal and significantly exceeded control for the next two days. 4. Urinary catecholamine excretion returned to pretreatment levels by 3 days but did not exceed control levels during the period of study. 5. Plasma noradrenaline returned gradually to pretreatment levels, and by day 4 significantly exceeded them. 6. No patient experienced symptoms suggesting catecholamine excess although four out of five reported a headache from the second day onwards. 7. Guanfacine, a centrally acting drug which pharmacologically resembles clonidine, has a slow offset of hypotensive effect over 2-3 days. Symptoms or biochemical evidence of catecholamine excess were not encountered within 48 h of withdrawal, possibly reflecting the longer duration of action and plasma half-life of guanfacine.
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PMID:Withdrawal of guanfacine after long-term treatment in essential hypertension. Observations on blood pressure and plasma and urinary noradrenaline. 700 59

A 39-year-old male patient with attacks of headache and tachycardia immediately after micturition is described. Systolic blood pressure of 250 mmHg was measured after voiding. Plasma noradrenaline was increased 10 to 20 times above the normal value during the attacks. Cystoscopy, arteriography, catheterization of the caval vein with sampling for plasma catecholamines and computerized tomography all supported the diagnosis of a bladder tumour. A beneficial effect of alpha-receptor blockade preoperatively was demonstrated. The tumour was operatively removed from the bladder. The postoperative course was uneventful.
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PMID:Pheochromocytoma of the bladder. A case report. 732 60


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