Prevention of menstrual attacks of migraine

MacGregor, Anne; Frith, Alison; Ellis, Jayne E.; Aspinall, L.; Hackshaw, Allan

doi:10.1212/01.wnl.0000249114.52802.55

Cited by 147 publications

(102 citation statements)

References 22 publications

(31 reference statements)

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“…15 Estradiol 1.5 mg (gel patch applied to the upper thigh or arm) was associated with a 22% reduction in migraine days (estradiol ϭ 133 migraine days, placebo ϭ 171 migraine days; relative risk [RR] 0.78; CI 0.62-0.99, p ϭ 0.04). This improvement was temporary, as subjects reported a 40% increase in migraine days in the 5 days following treatment (RR 1.40; CI 1.03-1.92, p ϭ 0.03).…”

Section: Co-q10 (Water-soluble Disbursable Form Of Co-q10)mentioning

confidence: 99%

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]

et al. 2012

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Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: Are nonsteroidal anti-inflammatory drugs (NSAIDs) or other complementary treatments effective for migraine prevention? Methods:The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications for migraine prevention. Results:The author panel reviewed 284 abstracts, which ultimately yielded 49 Class I or Class II articles on migraine prevention; of these 49, 15 were classified as involving nontraditional therapies, NSAIDs, and other complementary therapies that are reviewed herein.Recommendations: Petasites (butterbur) is effective for migraine prevention and should be offered to patients with migraine to reduce the frequency and severity of migraine attacks (Level A). Fenoprofen, ibuprofen, ketoprofen, naproxen, naproxen sodium, MIG-99 (feverfew), magnesium, riboflavin, and subcutaneous histamine are probably effective for migraine prevention (Level B). Treatments considered possibly effective are cyproheptadine, Co-Q10, estrogen, mefenamic acid, and flurbiprofen (Level C). Data are conflicting or inadequate to support or refute use of aspirin, indomethacin, omega-3, or hyperbaric oxygen for migraine prevention. Montelukast is established as probably ineffective for migraine prevention (Level B). Epidemiologic studies suggest approximately 38% of migraineurs need preventive therapy, but only 3%-13% currently use it.1 In 2000, the American Academy of Neurology (AAN) published guidelines for migraine prevention.2,3 Since then, new clinical studies have been published on the efficacy and safety of migraine preventive therapies. This guideline seeks to assess this new evidence to answer the following clinical question: For patients with migraine, which anti-inflammatory or complementary treatments are effective for prevention, as measured by reduced migraine attack frequency, reduced number of migraine days, or reduced attack severity? This article addresses the efficacy and safety of histamines/antihistamines; nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics; and several herbal, vitamin, and mineral preparations, whereas a companion article addresses standard pharmacologic treatments for migraine prevention.

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Section: Co-q10 (Water-soluble Disbursable Form Of Co-q10)mentioning

confidence: 99%

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]

et al. 2012

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“…Oral estrogens (Calhoun 2004;Somerville 1975) and percutaneous estradiol showed benefit during perimenstrual treatment, which was balanced when delayed by estrogen withdrawal, triggering post-dosing migraine immediately after the gel was stopped (MacGregor et al 2006a). Furthermore, rising levels of estrogen appear to offer some protection against migraine (MacGregor et al 2006b).…”

Section: Female Sex Hormone (Estrogen and Progesterone) Receptorsmentioning

confidence: 99%

“…Furthermore, rising levels of estrogen appear to offer some protection against migraine (MacGregor et al 2006b). Thus, estrogen patches have been utilized to prevent the rapid decline of estrogen levels during the menstrual cycle (MacGregor 2006;MacGregor et al 2006a;MacGregor et al 2006b;MacGregor and Hackshaw 2002;Magos et al 1983), which is thought to be the main trigger of migraine in these patients (MacGregor 2006). These studies have reported mixed results ranging from no improvement to 80% improvement and are also based on a relatively limited number of patients (n=11-38).…”

Section: Female Sex Hormone (Estrogen and Progesterone) Receptorsmentioning

confidence: 99%

Current and prospective pharmacological targets in relation to antimigraine action

Mehrotra

Gupta

Chan

et al. 2008

Naunyn-Schmied Arch Pharmacol

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Migraine is a recurrent incapacitating neurovascular disorder characterized by unilateral and throbbing headaches associated with photophobia, phonophobia, nausea, and vomiting. Current specific drugs used in the acute treatment of migraine interact with vascular receptors, a fact that has raised concerns about their cardiovascular safety. In the past, α-adrenoceptor agonists (ergotamine, dihydroergotamine, isometheptene) were used. The last two decades have witnessed the advent of 5-HT 1B/1D receptor agonists (sumatriptan and second-generation triptans), which have a well-established efficacy in the acute treatment of migraine. Moreover, current prophylactic treatments of migraine include 5-HT 2 receptor antagonists, Ca 2+ channel blockers, and β-adrenoceptor antagonists. Despite the progress in migraine research and in view of its complex etiology, this disease still remains underdiagnosed, and available therapies are underused. In this review, we have discussed pharmacological targets in migraine, with special emphasis on compounds acting on 5-HT (5-HT 1-7 ), adrenergic (α 1 , α 2, and β), calcitonin gene-related peptide (CGRP 1 and CGRP 2 ), adenosine (A 1 , A 2 , and A 3 ), glutamate (NMDA, AMPA, kainate, and metabotropic), dopamine, endothelin, and female hormone (estrogen and progesterone) receptors. In addition, we have considered some other targets, including gamma-aminobutyric acid, angiotensin, bradykinin, histamine, and ionotropic receptors, in relation to antimigraine therapy. Finally, the cardiovascular safety of current and prospective antimigraine therapies is touched upon.

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“…Maintaining luteal phase oestrogen levels can prevent menstrual attacks [MacGregor et al 2006;Somerville, 1975aSomerville, , 1975bSomerville, , 1972. Doses equivalent to 1.5 mg estradiol gel allow a mean estradiol plasma level of 80 pg/ml to be reached.…”

Section: Estradiolmentioning

confidence: 99%

“…There is evidence that some women responding to oestrogen supplements experience delayed attacks when the supplements are discontinued [MacGregor et al 2006] Oestrogen 'withdrawal' migraine may occur if treatment is not continued until the rise in endogenous oestrogen. Although there are no trial data, clinical practice suggests that for these women the duration of supplement use can be extended until day 7 of the cycle, tapering the dose over the last 2 days.…”

Section: Estradiolmentioning

confidence: 99%

Review: Menstrual migraine: therapeutic approaches

MacGregor

2009

Ther Adv Neurol Disord

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The development of diagnostic criteria has enabled greater recognition of menstrual migraine as a highly prevalent and disabling condition meriting specific treatment. Although few therapeutic trials have yet been undertaken in accordance with the criteria, the results of those published to date confirm the efficacy of acute migraine drugs for symptomatic treatment. If this approach is insufficient, the predictability of attacks provides the opportunity for perimenstrual prophylaxis. Continuous contraceptive strategies provide an additional option for management, although clinical trial data are limited. Future approaches to treatment could explore the genomic and nongenomic actions of sex steroids.

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Prevention of menstrual attacks of migraine

Cited by 147 publications

References 22 publications

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]

Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]

Current and prospective pharmacological targets in relation to antimigraine action

Review: Menstrual migraine: therapeutic approaches

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