Sustained-Release Niacin for Prevention of Migraine Headache

Velling, David A.; Dodick, David W.; Muir, Jesse J.

doi:10.4065/78.6.770

Cited by 23 publications

(15 citation statements)

References 5 publications

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“…Niacin may act as a negative feedback regulator on the KP to shunt TRP into the 5-HT pathway, thus increasing plasma 5-HT levels. Niacin administration may be potentially useful as preventive therapy for migraine headache (Velling et al, 2003).…”

Section: Migrainementioning

confidence: 99%

Role of Kynurenines in the Central and Peripherial Nervous Systems

Németh¹,

Toldi²,

Vécsei

2005

CNR

155

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Kynurenine (KYN) is an intermediate in the pathway of the metabolism of tryptophan to nicotinic acid. KYN is formed in the mammalian brain (40%) and is taken up from the periphery (60%), indicating that it can be transported across the blood-brain barrier (BBB). In the brain, KYN can be converted to two other components of the pathway: the neurotoxic quinolinic acid (QUIN) and the neuroprotective kynurenic acid (KYNA). QUIN is probably the most widely studied metabolite of KYN, because it may cause excitotoxic neuronal cell loss and convulsions by interacting with the N-methyl-D-aspartate (NMDA) receptor complex, a type of glutamate receptor. KYNA is another metabolite of KYN; its synthesis is catalysed by KYN aminotransferases. This is the only known endogenous NMDA receptor inhibitor, which can act at the glycine site on the receptor complex. Furthermore, KYNA non-competitively inhibits alpha7 nicotinic acetylcholine presynaptic receptors (nAChRs), inhibiting glutamate release, and regulates the expression of alpha4beta2 nAChR. It is well-known that the activation of excitatory amino acid (EAA) receptors can play a role in a number of neurodegenerative disorders, such as Parkinson's disease, Alzheimer's disease, stroke and epilepsy. Various studies have been made of whether the EAA receptor antagonist KYNA can exert a therapeutic effect in these neurological disorders. It has been established that KYNA has only a very limited ability to cross the BBB. Other KYNA derivatives have been synthesised (e.g. glucosamine-KYNA, 4-chloro-KYNA and 7-chloro-KYNA), which are well transported across the BBB and act on the glutamate receptors. Moreover, it has been demonstrated that probenecid, a known inhibitor of the transport of organic acids (e.g. KYNA), increases the cerebral concentration of KYNA. There is another new perspective to the maintenance of a high level of KYNA in the brain: the use of enzyme inhibitors, which can block the synthesis of the neurotoxic QUIN. These are some of the most promising possibilities as novel therapeutic strategies for the treatment of neurodegenerative diseases, in which the hyperactivation of amino acid receptors could be involved. The presence and importance of KYN derivatives in the periphery are also discussed in the light of recent publications.

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Section: Migrainementioning

confidence: 99%

Role of Kynurenines in the Central and Peripherial Nervous Systems

Németh¹,

Toldi²,

Vécsei

2005

CNR

155

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“…Hiperlipideminin migrene etkisi Gökçe ve ark. (22) tarafından ele alınmış ve özellikle hipertrigliserideminin periferal damarlarda vazodilatasyona ve artan kan akımına neden olduğu belirtilmiştir (23) . Saberi ve ark.…”

Section: Discussionunclassified

Headache in hyperlipidemia patients

Baş¹,

Demirci²,

Arslan³

et al. 2015

Terh

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ÖZETAmaç: Baş ağrısı, genel polikliniklere en sık başvuru nedenlerdendir. Son yıllarda metabolik sendrom, obezite ve primer baş ağrıları arasındaki ilişki dikkati çekmekte-dir. Amacımız hiperlipidemi ve baş ağrısı arasındaki ilişkiyi araştırmaktadır. Yöntemler: Lipid düzeyleri ölçülerek uluslararası kolesterol eğitim programı erişkin tedavi paneli III (NCEP ATP III) kriterlerine göre hiperlipidemi tanısı alan 92 kişi ve sağlıklı 100 kişi çalışmaya dâhil edildi. Tüm kişilerde baş ağrısının varlığı, süresi, sıklığı, atak süresi ve ağrının şiddeti araştırıldı. Bulgular: Katılımcıların yaş ortalamaları 37±13,8 yıldı. Yüz altısı (%55,2) kadın, 86'sı (%44,8) erkekti. İki grup yaş ve cinsiyet olarak benzerdi. Hiperlipidemi grubunda, 30 (%32,6) kontrol grubunda 16 (%16,0) kişide baş ağrısı tespit edildi. Hiperlipidemi grubunda baş ağrısı varlığı istatistiksel olarak anlamlı şekilde yüksekti (p=0.04). Baş ağrısı tipleri arasında anlamlı fark yoktu (p=0,9). Hiperlipidemili hastalarda atak şiddeti ve atak süresi kontrole göre daha yüksek bulundu (p=0,003, p=0,04). Sonuç: Çalışmamız hiperlipidemili hastalarda baş ağrısının sık olabileceğini göster-mektedir. Bu nedenle klinisyenler hiperlipidemili hastalarda baş ağrısının farkında olmalıdır.Anahtar kelimeler: Baş ağrısı, hiperlipidemi, migren ABSTRACT Objective: Headache is the most common complaint of the patients, who applied to general outpatient clinics. In recent years, association between metabolic syndrome, obesity, and primary headaches has attracted much attention. Our aim was to investigate the association between headache and hyperlipidemia. Methods: Ninety-two participants with hyperlipidemia and 100 healthy controls were enrolled in this study. The diagnosis of hyperlipidemia was made according to National Cholesterol Education Program Adult Treatment Panel III criteria. We investigated the presence, duration, frequency, severity of headache, the duration of headache attack. Results: Mean age of the participants was 37±13.8 years. Of all participiants, 106 (55.2%) were females, 86 (44.8%) were males. Two groups were similar in terms of gender and age. In the hyperlipidemia group, 30 (32.6%) patients had headache, and in the control group 16 (16.0%) cases had headache. This difference was statistically significant (p=0.04). There was no statistically significant difference between the groups according to the type of headache (p=0.9). The patients with hyperlipidemia had significantly higher VAS and prolonged headache attacks compared to the controls (p=0.003, p=0.04). Conclusions: Our study suggests that headache may be frequent in hyperlipidemia patients. Therefore, clinicans should be aware of headache in hyperlipidemia patients. Araşt. Hast. Dergisi 2015; 25(3):186-190 doi:10.5222/terh.2015.186 Gİrİş Baş ağrısı, nöroloji ve genel polikliniklere başvu-ran hastaların en sık başvuru nedenlerinden biridir. Ülkemizde baş ağrısı nedeni ile doktora başvuru oranı %38,9 olup, bu oran kadınlarda %46,1, erkek-

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“…A total of 14 articles were screened [6,7,9-20]. Five articles were excluded in total; three because niacin was not the sole therapeutic agent used for the treatment of headache [16], histaminic cephalgia [17], and migraine [20]; and two because the reports were opinion pieces without any objective or subjective data to support the assertions made [13,19].…”

Section: Methodsmentioning

confidence: 99%

“…Five articles were excluded in total; three because niacin was not the sole therapeutic agent used for the treatment of headache [16], histaminic cephalgia [17], and migraine [20]; and two because the reports were opinion pieces without any objective or subjective data to support the assertions made [13,19]. In total, nine articles were found to meet the inclusion criteria and were included in this systematic review [6,7,9-12,14,15,18]. Table 2 displays the characteristics of the studies included in this review.…”

Section: Methodsmentioning

confidence: 99%

“…Niacin is a well-known over-the-counter (OTC) supplement primarily used for its ability to favorably influence cholesterol levels. Recently, there have been anecdotal reports demonstrating the effectiveness of niacin for aborting acute migraine attacks [6], and for preventing migraine headaches [7]. To assess the therapeutic spectrum of niacin's clinical effectiveness, we conducted a systematic review of the literature to examine the evidence of intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature

Prousky

Seely

2005

Nutr J

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BackgroundMigraine and tension-type headaches impose a tremendous economic drain upon the healthcare system. Intravenous and oral niacin has been employed in the treatment of acute and chronic migraine and tension-type headaches, but its use has not become part of contemporary medicine, nor have there been randomized controlled trials further assessing this novel treatment. We aimed to systematically review the evidence of using intravenous and/or oral niacin as a treatment for migraine headaches, tension-type headaches, and for headaches of other etiologic types.MethodsWe searched English and non-English language articles in the following databases: MEDLINE (1966–February 2004), AMED (1995–February 2004) and Alt HealthWatch (1990–February 2004).ResultsNine articles were found to meet the inclusion criteria and were included in this systematic review. Hypothetical reasons for niacin's effectiveness include its vasodilatory properties, and its ability to improve mitochondrial energy metabolism. Important side effects of niacin include flushing, nausea and fainting.ConclusionAlthough niacin's mechanisms of action have not been substantiated from controlled clinical trials, this agent may have beneficial effects upon migraine and tension-type headaches. Adequately designed randomized trials are required to determine its clinical implications.

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Sustained-Release Niacin for Prevention of Migraine Headache

Cited by 23 publications

References 5 publications

Role of Kynurenines in the Central and Peripherial Nervous Systems

Role of Kynurenines in the Central and Peripherial Nervous Systems

Headache in hyperlipidemia patients

The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature

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