Octreotide Dependency and Headache: A Case Report

May, Arne; Lederbogen, S; Hc, Diener

doi:10.1046/j.1468-2982.1994.1404303.x

Cited by 18 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Somatostatin analogues may have an immediate analgesic effect in patients with pituitary tumour‐related headache unrelated to opiate mechanisms (Pascual et al ., 1991), without reduction in the size of the lesion (Schmidt et al ., 1993). Indeed octreotide, a synthetic somatostatin analogue, has also been reported to be useful in cluster headache (Sicuteri et al ., 1984; Otsuka et al ., 1998), and to produce medication‐induced headache (May et al. , 1994; Popovic et al ., 1988).…”

Section: Discussionmentioning

confidence: 99%

Prolactinomas, dopamine agonists and headache: two case reports

Levy

Matharu

Goadsby

2003

Euro J of Neurology

102

View full text Add to dashboard Cite

Headache is a common problem in patients with pituitary tumours. Small pituitary lesions can cause debilitating headache, suggesting that the size of the pituitary tumour may not be the only causal factor in pituitary-related headache. We present two cases of prolactinoma-associated headache. The first case has a clinical diagnosis of short-lasting unilateral headache attacks with conjunctival injection and tearing (SUNCT). The second case has a clinical diagnosis of hemicrania continua and idiopathic stabbing headache. In each case, the administration of dopamine agonists has led to an exacerbation of symptoms. We review the relevant literature to understand the pathophysiological implications of these cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Prolactinomas, dopamine agonists and headache: two case reports

Levy

Matharu

Goadsby

2003

Euro J of Neurology

102

View full text Add to dashboard Cite

show abstract

“…It is possible that our patient could have developed octreotide dependency [11][12][13] regarding headache during the therapy. However, we must note that tachyphylaxis to octreotide did not emerge and that almost the same dose of octreotide has been effective to relieve the headache during the 4-year observation period, while the occurrence of octreotide tachyphylaxis on GH reduction has only rarely been reported in acromegaly [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Long-term Effects of Octreotide on Pituitary Gigantism: Its Analgesic Action on Cluster Headache

et al. 2004

View full text Add to dashboard Cite

Abstract. We report the case of 19-year-old man with pituitary gigantism due to growth hormone-producing pituitary macroadenoma. The patient complained of recurrent headache and excessive growth spurt since age 15. Octreotide administration was initiated following transsphenoidal pituitary adenomectomy. Octreotide injection for 4 years efficaciously reduced the size of remnant adenoma as well as serum growth hormone levels. Notably, octreotide exhibited a potent analgesic effect on his intractable cluster headache that has continued even after reduction of the adenoma volume. The analgesic effect lasted 2 to 6 hours after each injection and no tachyphylaxis to octreotide appeared during 4-year treatment. To characterize the headache and the pain intensity, analgesic drugs including octreotide, lidocaine, morphine and thiopental were tested using a visual analogue scale (VAS) evaluation, with the result that octreotide exhibited a prompt and complete disappearance of the headache. Headache relief was in part reproduced by morphine injection (56% reduction) but not by lidocaine or thiopental. The present case suggests that the intractable headache associated with pituitary gigantism is possibly related to the endogenous opioid system. Thus, the headache control by octreotide is clinically helpful for continuation of the self-injection regimen.

show abstract

“…The use of somatostatin analogues for analgesia alone cannot be routinely recommended because of the risk of developing a dependency syndrome. Somatostatin receptors are known to heterodimerize with opiate receptors and overuse of these agents for analgesia can lead to significant rebound headache and tachyphylaxis [46].…”

Section: Acromegalymentioning

confidence: 99%

The Association of Pituitary Tumors and Headache

Levy

2010

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

Pituitary tumors may give rise to headache via numerous mechanisms. The traditional explanation for headache is dural stretch and cavernous sinus invasion, although this is not borne out by clinical studies. Certain functional pituitary tumors are associated with headache, notably growth hormone and prolactin-secreting tumors. The observation that somatostatin analogues can have a dramatic analgesic effect in acromegaly suggests that biochemical properties of the tumor may be important. The genetic predisposition of the patient to primary headache also determines whether headache occurs with pituitary tumors. This article attempts to outline the clinical features, management strategies, and key academic questions regarding the subject of pituitary tumors and headache.

show abstract

Octreotide Dependency and Headache: A Case Report

Cited by 18 publications

References 20 publications

Prolactinomas, dopamine agonists and headache: two case reports

Prolactinomas, dopamine agonists and headache: two case reports

Long-term Effects of Octreotide on Pituitary Gigantism: Its Analgesic Action on Cluster Headache

The Association of Pituitary Tumors and Headache

Contact Info

Product

Resources

About