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alleyoop

Warfarin for Refractory Chronic Cluster Headache

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Damn, Bob! This looks really interesting. The statistical analysis, even in the abstract, is beyond me but I would like to read the whole report. The study is brand new; it's from the May issue of Headache journal. Warfarin is still used occasionally as an effective rat poison - which shouldn't concern us lol - and may have been used by Khrushchev and friends in an attempt to poison Stalin. This drug looks very promising.

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There's a little more information, including this >>>It's unclear what the underlying mechanism may be, says Dr. Hakim, but it's unlikely to involve any direct anti-inflammatory action. "An apparently more plausible hypothesis may be related to vitamin K," he suggests, "which seems to exert biologically relevant actions on dendritic and neuronal metabolism."<<< at http://www.medbioworld.com/news.php?topic=0&article=20110422clin010.xml

This is of course follow-up to an earlier "accidental" observation about warfarin for CH and a small follow-up study: http://www.ouch-us.org/medications/warfarin.htm

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More and more information. This is brand new, happening now stuff. Exciting stuff. Exciting to me, anyway. But I'm old and easy to please. I think it's worth asking our Doctors about. I'm going to email the abstract to ours.

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Aside from the anti-coagulant as a treatment for CH, this is one of the best studies about CH treatment I've seen so far.  Dr. Hakim seems to have crossed all T's and dotted all I's.

Hopefully the upcoming studies about BOL will have a similar study design.

Thanks cluster!

bobb

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Good stuff. Who among us will be the first to ask their doctor for a prescription?

We have all tried way more radical treatments and the science seems to be there...so far so good anyway.

Thanks for the post Bobb

Dan

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Mikes doctor OFFERED to write mike the necessary Rx's after I emailed him a copy of the abstract. If, after withdrawal from the Methadone, Michael still can't bust with the psychedelics, we'll take him up on it.

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It really looks promising. Why not? I am doing really well these days/months or I would sure give it a try.

Let us know if Mike tries it. Wouldn't that be great if one of the toughest cases found relief from a legal and prescribed, easily accessible drug.

Aspirin is a blood thinner by the way. :o

Dan

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I filled the script for the Warfarin and Mike took the 1st dose a little while ago. He's going to take 2.0mg/day till he sees the Doc and gets some blood tests. Away we go; crossing fingers and toes. Btw, the script cost less than $10 for a 30-day supply.

Ron

p.s. - Danny, every time I see your cute little avatar, I get moist. Can't help it. You are SO adorable!

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Hell yes and right on for Mike.

Tell him thanks from me/us for being the guinea pig. Tell tripod hey from Texas. ;D

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Mike's noticed nothing from the Warfarin. He's only taking 2.0mg/day. All participants in the trial busted as they were increasing their dosages from 2.0 up to about 10.0mg/day. He'll see the doctor tomorrow with results from 1st blood test which provides a baseline.

Ron

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Keeping fingers crossed for Michael and you Ron.

Guess we will have to wait till you get up to 10.0mg/day.

- Matty

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Quote: "In order to optimize the therapeutic effect without risking dangerous side effects (of warfarin), such as bleeding, close monitoring of the degree of anticoagulation is required by blood testing (INR). During the initial stage of treatment, checking may be required daily; intervals between tests can be lengthened if the patient manages stable therapeutic INR levels on an unchanged warfarin dose."

From http://en.wikipedia.org/wiki/Warfarin

For an explanation of "INR" = "International Normalized Ratio" please see

http://en.wikipedia.org/wiki/Prothrombin_time

In Sameh M. Hakim's pilot study the target INR was between 1.5 - 1.9 http://www.ncbi.nlm.nih.gov/pubmed/21395575

Quote from a case report:

"With the start of oral anticoagulant, there was a reduction in the frequency of cluster headache crises. They were no longer daily, but the complete remission was not achieved. On July 11, as the INR was still of 1.8, warfarin was increased to 10 mg/day, obtaining a INR > 2.5. From then on, the patient did not present headache. Prednisone and divalproate sodium were gradually reduced and, finally, discontinuated, and verapamil (480 mg/day) was maintained with no recurrence of the crises."

Source: http://dx.doi.org/10.1590%2FS0004-282X2004000600029

More case reports about warfarin + CH:

http://www.ncbi.nlm.nih.gov/pubmed/16362716?dopt=Abstract

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Hipshot, Aspirin isn't a blood thinner it inhibts the action of platlets which is a different matter and so it's probably useless for CH.

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