Hypnic Headache: Another Indomethacin-Responsive Headache Syndrome?

Dodick, David W.; Jones, Jeffrey S.; Capobianco, David J.

doi:10.1046/j.1526-4610.2000.00150.x

Cited by 68 publications

(52 citation statements)

References 15 publications

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“…A good response was also noted with lower doses, even 150 mg at bedtime [8]. Out of the patients treated with lithium, this drug was discontinued in 5 cases [1, 31–33] despite its efficacy, due to significant adverse effects. Poor tolerability to lithium is not rare, mainly in elderly patients.…”

Section: Treatmentmentioning

confidence: 99%

“…The efficacy of indomethacin is of special interest because this drug is also effective in paroxysmal hemicrania and hemicrania continua [36]. It has been suggested that indomethacin may be helpful in those patients whose HH attacks are unilateral [31]. It was shown to be effective in extremely variable doses, ranging from 25 mg to 150 mg/day.…”

Section: Treatmentmentioning

confidence: 99%

“…Some patients who responded to indomethacin before bedtime developed daytime headaches, which resolved after indomethacin was discontinued. This phenomenon was termed as “the paradox of indomethacin”, whose most prominent side effect and reason for discontinuation (headache) is the very symptom for which it provides a remarkable therapeutic efficacy [31]. Other patients reported a good response to indomethacin, but could not tolerate it [21, 37].…”

Section: Treatmentmentioning

confidence: 99%

“…casesEfficacyGoodModerateNoneAcetylsalicylic acid[18, 39]211Acetylsalicylic acid + caffeine[27]11Caffeine[35, 41]312Acetaminophen[4, 19, 33, 40]4112Sumatriptan 50 mg + caffeine[27]11Nimesulide[19, 32, 33, 42]413Ibuprofen[5, 32]211Triptans others than sumatriptan[5, 32, 33, 39]413Ergotamine[40]11Sumatriptan 50–100 mg[5, 19, 31, 33]44Oxygen inhalation…”

Section: Treatmentmentioning

confidence: 99%

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Focus on therapy of hypnic headache

Lisotto¹,

Rossi²,

Tassorelli

et al. 2010

J Headache Pain

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Hypnic headache (HH) is a primary headache disorder, which occurs exclusively during sleep and usually begins after 50 years of age. There are no controlled trials for the treatment of HH. We reviewed all the available papers, including 119 cases published in literature up to date, reporting the efficacy of the medications used to treat HH. Acute treatment is not recommended, since no drug proved to be clearly effective and also because the intensity and the duration of the attacks do not require the intake of a medication in most cases. As for prevention, a wide variety of medications were reported to be of benefit in HH. The drugs that were found to be effective in at least five cases are: lithium, indomethacin, caffeine and flunarizine. Lithium was the most extensively studied compound and demonstrated to be an efficacious treatment in 32 cases. Unfortunately, despite its efficacy, significant adverse effects and poor tolerability are not rare, mainly in elderly patients. Many patients reported a good response to indomethacin, but some could not tolerate it. Caffeine and melatonin treatments did not yield robust evidence to recommend their use as single preventive agents. Nevertheless, their association with lithium or indomethacin seems to produce an additional therapeutic efficacy. A course of lithium should be tried first, followed 3–4 months later by tapering. If headache recurs during tapering, a longer duration of therapy may be needed. If lithium treatment does not provide a significant response, indomethacin can be commenced as second-line approach. If these treatments prove to be ineffective or poorly tolerated, other agents, such as caffeine and melatonin, can be administered.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Focus on therapy of hypnic headache

Lisotto¹,

Rossi²,

Tassorelli

et al. 2010

J Headache Pain

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show abstract

“…Lithium is the most effective drug for prophylactic treatment of HH. Indomethacin has been suggested to be helpful in unilateral HH [7]. We report a case of relapsing–remitting variety of HH in an adolescent who showed complete response to indomethacin.…”

Section: Introductionmentioning

confidence: 97%

Relapsing remitting hypnic headache responsive to indomethacin in an adolescent: a case report

Prakash

Dabhi

2008

J Headache Pain

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Hypnic headache (HH) is a rare sleep-associated primary headache disorder that usually begins after the age of 60 years. Here we report a 19-year-old male with 4-year history of predominantly left sided HH. He is the youngest person reported who fulfills the IHS diagnostic criteria for HH. The patient had history of relapsing–remitting course. The headache occurred every night at a constant time in each relapse. It was non-throbbing, moderate to severe, for 30 min to 5 h, and usually after 3 h of sleep. The patient showed complete response to indomethacin (75 mg at bedtime). Frequent tapering of indomethacin was required to look for the remission phase.

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Unusual Short‐duration Primary Headaches

Vollbracht

Grosberg

2013

Headache

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Hypnic Headache: Another Indomethacin-Responsive Headache Syndrome?

Cited by 68 publications

References 15 publications

Focus on therapy of hypnic headache

Focus on therapy of hypnic headache

Relapsing remitting hypnic headache responsive to indomethacin in an adolescent: a case report

Unusual Short‐duration Primary Headaches

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