Dipyridamole may induce migraine in patients with migraine without aura
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Dipyridamole may induce migraine in patients with migraine without aura. / Kruuse, C; Lassen, L H; Iversen, Helle Klingenberg; Oestergaard, S; Olesen, J.
In: Cephalalgia : an international journal of headache, Vol. 26, No. 8, 08.2006, p. 925-33.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Dipyridamole may induce migraine in patients with migraine without aura
AU - Kruuse, C
AU - Lassen, L H
AU - Iversen, Helle Klingenberg
AU - Oestergaard, S
AU - Olesen, J
PY - 2006/8
Y1 - 2006/8
N2 - Dipyridamole inhibits phosphodiesterase 5 (PDE5) and adenosine re-uptake. The most prominent side-effect is headache. We examined the migraine-generating effects of dipyridamole as well as the cerebral blood velocity response in a single-blind study, including 10 patients with migraine without aura and 10 healthy subjects. Dipyridamole 0.142 mg/kg per min was administered intravenously. Headache intensity was scored on a verbal rating scale along with pain characteristics and accompanying symptoms. Blood velocity in the middle cerebral artery (V(mca)), blood pressure and heart rate were recorded repeatedly. Headache was induced in all migraine patients and in eight of 10 healthy subjects (P = 0.47) with no significant difference in headache intensity (P = 0.53). However, five patients but only one healthy subject experienced the symptoms of migraine without aura, according to ICHD-2 criteria, within 12 h (P = 0.14). Four patients reported photophobia after dipyridamole compared with no healthy subjects (P = 0.087). V(mca) decreased (P < 0.001) during and after dipyridamole infusion with no difference between groups (P = 0.15) coinciding with initiation, but not cessation of immediate headache. Thus, dipyridamole induces symptoms of migraine and an initial decrease in V(mca) in migraine patients, but not significantly more than in healthy subjects. This relatively low frequency of migraine induction, compared with nitric oxide donors and sildenafil, is probably due to the less specific action of dipyridamole on the cGMP signalling pathway as well as a possible bidirectional effect of adenosine on migraine induction.
AB - Dipyridamole inhibits phosphodiesterase 5 (PDE5) and adenosine re-uptake. The most prominent side-effect is headache. We examined the migraine-generating effects of dipyridamole as well as the cerebral blood velocity response in a single-blind study, including 10 patients with migraine without aura and 10 healthy subjects. Dipyridamole 0.142 mg/kg per min was administered intravenously. Headache intensity was scored on a verbal rating scale along with pain characteristics and accompanying symptoms. Blood velocity in the middle cerebral artery (V(mca)), blood pressure and heart rate were recorded repeatedly. Headache was induced in all migraine patients and in eight of 10 healthy subjects (P = 0.47) with no significant difference in headache intensity (P = 0.53). However, five patients but only one healthy subject experienced the symptoms of migraine without aura, according to ICHD-2 criteria, within 12 h (P = 0.14). Four patients reported photophobia after dipyridamole compared with no healthy subjects (P = 0.087). V(mca) decreased (P < 0.001) during and after dipyridamole infusion with no difference between groups (P = 0.15) coinciding with initiation, but not cessation of immediate headache. Thus, dipyridamole induces symptoms of migraine and an initial decrease in V(mca) in migraine patients, but not significantly more than in healthy subjects. This relatively low frequency of migraine induction, compared with nitric oxide donors and sildenafil, is probably due to the less specific action of dipyridamole on the cGMP signalling pathway as well as a possible bidirectional effect of adenosine on migraine induction.
KW - Administration, Oral
KW - Adult
KW - Dipyridamole
KW - Female
KW - Headache Disorders, Secondary
KW - Humans
KW - Male
KW - Middle Aged
KW - Migraine without Aura
KW - Risk Assessment
KW - Risk Factors
KW - Single-Blind Method
KW - Treatment Outcome
KW - Vasodilator Agents
U2 - 10.1111/j.1468-2982.2006.01137.x
DO - 10.1111/j.1468-2982.2006.01137.x
M3 - Journal article
C2 - 16886928
VL - 26
SP - 925
EP - 933
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 8
ER -
ID: 128983390