Verapamil in the prophylaxis of episodic cluster headache: A double-blind study versus placebo

Leone, Massimo; D’Amico, Domenico; Frediani, Fabio; Moschiano, F.; Grazzi, Licia; Attanasio, A.; Bussone, Gennaro

doi:10.1212/wnl.54.6.1382

Cited by 222 publications

(173 citation statements)

References 7 publications

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“…This has been shown to be effective at a dose of 360 mg daily, 57 though in some cases patients may benefi t from titration of the dose as high as 960 mg daily. Patients may experience dizziness, fatigue and constipation on this medication, and the ECG should be checked regularly (even when established on a stable dose) to look for the development of a prolonged PR interval and ultimately heart block.…”

Section: Preventive Treatment For Cluster Headachementioning

confidence: 99%

Drug therapy in headache

Weatherall

2015

Clinical Medicine

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All physicians will encounter patients with headaches. Primary headache disorders are common, and often disabling. This paper reviews the principles of drug therapy in headache in adults, focusing on the three commonest disorders presenting in both primary and secondary care: tension-type headache, migraine and cluster headache. The clinical evidence on the basis of which choices can be made between the currently available drug therapies for acute and preventive treatment of these disorders is presented, and information given on the options available for the emergency parenteral treatment of refractory migraine attacks and cluster headache.

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Section: Preventive Treatment For Cluster Headachementioning

confidence: 99%

Drug therapy in headache

Weatherall

2015

Clinical Medicine

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“…Mittel der 1. Wahl ist Verapamil, das rasch auf 480 mg/Tag erhöht wird, in Ausnahmefällen und unter EKG-Kontrollen auch auf 720-960 mg/Tag [2,3,4,11,16,21,23,24]. Eine zusätzliche abendliche Gabe von Naratriptan, welches möglicherweise bei Clusterkopfschmerz eine gewisse prophylaktische Wirkung besitzt, kann die Effizienz von Verapamil steigern [26].…”

Section: Therapieoptionenunclassified

Behandlung eines atypischen und therapierefraktären Clusterkopfschmerzes mit Topiramat

Kuhn

Bewermeyer

2006

Schmerz

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Cluster headache is the third most frequent type of primary cephalgia only exceeded in frequency by tension-type headache and migraine. Cluster headache is characterized by periodic attacks of unilateral excruciating pain and accompanying autonomic features. It is arguably the most disabling form of primary headache. Therefore, prompt recognition of this disorder is necessary to provide an opportunity for effective treatment. We report on a patient with cluster headache, who complained about an atypical interval of dull headache between the cluster attacks, thus excluding the differential diagnosis of hemicrania continua. The common drugs for acute cluster attacks proved to be ineffective as well as prophylactic treatment with steroids and verapamil. Only administration of topiramate led to relief of pain.

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“…In an open-label study on 48 patients, two thirds improved significantly with the treatment [25,Class IIIa1]. In a double-blind, placebo-controlled trial on 15 patients with the episodic form of the disease, 360 mg of verapamil, as well as use of abortive medication, proved statistically significant for the reduction of the frequency of CH attacks [26,Class I]. Despite the considerable dosages sometimes used, side effects, including hypotension, are uncommon.…”

Section: Calcium Channel Blockersmentioning

confidence: 99%

Cluster headache and cluster variants

Lenaerts

2003

Curr Treat Options Neurol

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Patients must be cognizant of the time course of the cluster headache periods to optimally tailor their therapy. Steroids provide the fastest onset of prophylactic effect. Once steroids are initiated, it remains difficult to wean patients off of them, and that is why it is always recommended to associate another prophylactic agent from the onset with the steroids. All triptans can be considered; however, only injectable sumatriptan and zolmitriptan have been the subject of controlled studies, and the former remains the gold standard because of its speed of action. Lithium, although not a first-line therapy, remains mainly efficacious for the chronic form of cluster headache. There does not seem a significant tendency for analgesic rebound-withdrawal headache with cluster headache compared with migraine. Scientific studies of the treatment of cluster headache are inherently difficult because of the rarity of the syndrome, the short duration of attacks, and the relatively short duration of the cluster period, along with the presence of spontaneous remissions. Moreover, still a significant proportion of the available evidence on this subject is uncontrolled. Active, rather than placebo, control individuals are recommended. As far as surgical procedures are concerned, although only recently introduced and less documented, gamma-knife radiosurgery should be preferred to the procedures associated with craniotomy, which are inherently associated with a higher complication potential risk.

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Verapamil in the prophylaxis of episodic cluster headache: A double-blind study versus placebo

Cited by 222 publications

References 7 publications

Drug therapy in headache

Drug therapy in headache

Behandlung eines atypischen und therapierefraktären Clusterkopfschmerzes mit Topiramat

Cluster headache and cluster variants

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