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Showing content with the highest reputation on 12/22/2019 in all areas

  1. Hoping you are getting closer to success, Siegfried. I have wondered why Indo, but not other anti-inflammatories, is the best treatment for hemicranias. Found this today, which partly resolves my curiosity about that: "Indomethacin is one of the cyclooxygenase 1 inhibitors with the highest penetration rate in the blood-brain barrier.1 Indomethacin, but not other NSAIDs (ie, naproxen and ibuprofen), was found to inhibit nitrous oxide-dependent vasodilation. Other medications that could be considered for HC include topiramate, lamotrigine, naproxen, lithium, onabotulinumtoxinA, and melatonin." It's from a good recent article with good additional references: https://www.clinicalpainadvisor.com/home/topics/migraine-headache/hemicrania-continua-diagnosis-and-treatment/ (Melatonin is frequently mentioned in the literature as having a structure very similar to Indomethacin.)
    2 points
  2. @EyecePick, thanks for letting us know. I sure hope this helps you. Same to you @Siegfried. I would add that while it is indeed very unusual for headache to respond to both triptans and indomethacin, it might not be completely unheard of. Table 1 here shows that a small percentage of people with PH did respond to triptans, at least to some extent: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519518/ Can't say that those people also responded to Indocin, but the fact that some hemicrania patients responded to sumatriptan as an abortive, and one achieved full relief, at least seems to mean that it's not impossible. And there is this one reported case of a woman who was thought to have CH and sumatriptan injections stopped her attacks within 15 minutes, but then it was realized that she had CPH and Indocin virtually eliminated her pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170242/ With all the complexities of diagnosis and treatment in this area, I'm disinclined to hold to any absolutes.
    2 points
  3. ......and when it comes to CH .....I am INCLINED to absolutely believe exactly this...well said!
    1 point
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