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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 49 (1996), S. 335-339 
    ISSN: 1432-1041
    Keywords: Migraine ; Histamine ; nitric oxide ; glyceryl trinitrate ; cerebral arteries ; transcranial Doppler
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract It has previously been shown that in migraine sufferers infusion of glyceryl trinitrate (GTN) and histamine causes an immediate headache during the infusion and a genuine migraine attack one to several hours after the infusion. This identical time profile indicates a common mechanism of action. To evaluate whether GTN causes headache via liberation of histamine, we studied the effect of GTN 0.5 ώg · kg−1·min−1 for 20 min in seven migraine sufferers, once after pretreatment with the histamine-1(H1)-receptor blocker mepyramine (0.5 mg · kg−1) and once without pretreatment. This mepyramine dose is known to completely abolish histamine-induced headache. After pretreatment with mepyramine five patients experienced migraine, and without pretreatment six patients did so. The median peak headache score was 7 on a 0–10 scale with and without mepyramine pretreatment. The arterial responses, evaluated with transcranial Doppler, were also unaffected by the mepyramine pretreatment. Our results demonstrate that neither headache nor arterial dilatation due to GTN infusion is caused by histamine release. In all likelihood the common mediator of migraine induction by GTN and histamine is nitric oxide.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 238 (1991), S. S23 
    ISSN: 1432-1459
    Keywords: Migraine ; Antimigraine therapy ; Migraine trigger factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The current treatments available for migraine are reviewed and may be classified into four basic types. (a) Identification and elimination of migraine trigger factors, which include stress, emotions, fatigue, certain foods and beverages, and certain medications such as oestrogen therapy. (b) Symptomatic treatment of individual attacks. This includes various non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and paracetamol, and ergotamine, dihydroergotamine and phenothiazines. Morphinomimetics, which are often given for migraine, should really be avoided. (c) Prophylactic treatment which is particularly recommended for patients averaging two or more severe migraine attacks per month. Useful drugs include: ß-adrenergic receptor blockers as first choice, e.g. propranolol, timolol, nadolol and metoprolol; 5-hydroxytryptamine blockers, e.g. pizotifen and methysergide; calcium channel blockers; dihydroergotamine; and NSAIDs. (d) Non-drug treatment which is best combined with identification and elimination of trigger factors, and the use of various relaxation techniques. These four treatment types are covered in some detail, however it is clear that none of them is ideal and side-effects present a problem. Clearly, the continued research and development of novel and specific drugs for migraine is vital.
    Type of Medium: Electronic Resource
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