Chronic daily
headache

Spierings, Egilius L.H.

doi:10.1007/s10194-003-0045-6

Cited by 8 publications

(9 citation statements)

References 30 publications

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“…Current strategies for CM treatment include hospitalization, disruption of abortive medications with the use of corticosteroids, ergot alkaloids such as dihydroergotamine, and enhancement of prophylactic agents such as amitriptyline 5 . To date, only topiramate and botulinum toxin type A have shown efficacy for CM in several randomized controlled trials 6,7 . Outpatient management may further involve behavioral modification and biofeedback therapies.…”

mentioning

confidence: 99%

Implanted Auriculotemporal Nerve Stimulator for the Treatment of Refractory Chronic Migraine

et al. 2010

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mentioning

confidence: 99%

Implanted Auriculotemporal Nerve Stimulator for the Treatment of Refractory Chronic Migraine

et al. 2010

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“…Secondary CDH refers to subjects with a potentially inciting event for CDH such as, for example, head injury, surgery, or severe infection. Spierings [15] compared 34 patients with CDH of abrupt onset with 51 subjects manifesting idiopathic onset with no previous event, and no differences potential precipitating events were found. In the Oklahoma University Headache Registry, the author compared ageand gender-matched subjects with idiopathic and posttraumatic CDH as to type of headache defined by 20 characteristics.…”

Section: Pathophysiology Of Chronic Daily Headachementioning

confidence: 87%

“…In the author's clinical experience, this appears a reasonable standard. The reviews of Spierings [15] and Silberstein [16] offer more detailed information.…”

Section: Definition and Classification Of Chronic Daily Headachementioning

confidence: 99%

Chronic daily headache

Couch

2003

Curr Treat Options Neurol

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The therapy of chronic daily headache (CDH) is complex and involves a combination of drugs, supportive psychotherapy, nondrug therapy, "tender-loving care," and "tough love." CDH is a chronic problem with exacerbations and remissions. Patients with CDH often manifest mood disorders, and recognition and treatment of these problems is a key component of success. The use of preventative antimigraine therapy is a major component of treatment of this condition. Patients with exacerbations may need judicious short courses of medications that can produce medication-overuse headache. Patients may switch to another physician to get opiates or other pain relief medications. The patient may later realize this mistake and return to the physician. Use of patient "contracts," in which the patient agrees not to take more than a prescribed amount of restricted medication or seek it elsewhere, may be helpful. In this area, there is no standard patient or standard therapeutic regimen. The treatment plan must be individualized for each patient. Taking a little extra time to talk with patients and discuss medications, procedures, and goals and objectives may pay bigger dividends in the therapeutic relationship later in the course of treatment.

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“…In addition, there seems to be continued interest in this product, possibly because of new indications. [3][4][5] Although metaxalone has been on the market for 40 years, there is relatively little known about the dissolution behavior of the marketed product, Skelaxin. These studies looked at the dissolution of metaxalone tablets with United States Pharmacopeia (USP) Apparatus 2 using water (pH undetermined), and 3 pH-controlled media: pH 1.5 simulated gastric fluid (SGF), pH 4.5, and pH 7.4 simulated intestinal fluid (SIF), with and without the addition of surfactant.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the dissolution of metaxalone tablets (Skelaxin) usingUSP apparatus 2 and 3

Cacace

Reilly²,

Amann³

2004

AAPS PharmSciTech

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Metaxalone is commercially available as a 400-mg tablet, brand name Skelaxin. This product was approved by the FDA in 1962. 6 It is interesting to note that the package insert for Skelaxin does not contain any patient dosing, pharmacokinetic, or formulation information. Nor is there an indication of whether the product should be taken with or without food. However, according to patent US 6 407 128 B1, 7 the bioavailability of Skelaxin increases if dosed with food.The purpose of this study was to evaluate the effect of pH on the dissolution behavior of metaxalone in the marketed product Skelaxin tablets. The dissolution was evaluated using United States Pharmacopeia (USP) dissolution Apparatus 2 and 3 at pHs ranging from 1.5 to 7.4. Results from these studies show that the dissolution of this product is pH dependent. At low pH (simulated gastric fluid, pH 1.5), the dissolution of metaxalone from Skelaxin tablets was less than 10% over 75 minutes; whereas, dissolution at pH 4.5 showed greater than 90% release in the same time period. These results were consistent for both Apparatus 2 and 3. This suggests that Skelaxin Tablets should be considered a delayed release dosage form. According to AHFS Drug Information 2001,8 "following oral administration of a single 800 mg dose of metaxalone, mean peak plasma concentrations are attained in 2 hours. The onset of action is usually within 1 hour and the duration of action is about 4 to 6 hours. The drug has a plasma halflife of 2-3 hours. Metaxalone is metabolized in the liver and excreted in urine as unidentified metabolites." (p. 1331) Although, there is not much information on the metabolism of metaxalone in the literature, the chemistry of the metabolic products was proposed by Bruce et al.1 Several metabolites were identified, but no further information was found in the literature about the activity of these metabolites.

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Chronic daily headache

Cited by 8 publications

References 30 publications

Implanted Auriculotemporal Nerve Stimulator for the Treatment of Refractory Chronic Migraine

Implanted Auriculotemporal Nerve Stimulator for the Treatment of Refractory Chronic Migraine

Chronic daily headache

Comparison of the dissolution of metaxalone tablets (Skelaxin) usingUSP apparatus 2 and 3

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