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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> prophylactic meds
        
(Message started by: siddli on Feb 19^th, 2008, 7:35pm)

Title: prophylactic meds
Post by siddli on Feb 19^th, 2008, 7:35pm

after six and a half years constant headaches was prescribed candesartan cilexetil (amias) 16mg for high blood pressure due to prednisolone which was the only thing that gave relief.headaches tailed off and disappeared within ten days.coincidence?dunno but headache free for three months since.heard amias is being trialled for a prophylactic.worth a go if like me nothing else has worked.

Title: Re: prophylactic meds
Post by monty on Feb 19^th, 2008, 8:06pm

Good to hear your report. It could be a coincidence, or there could be something to it. Candesartan blocks angiotensin II receptors both in the brain and in the blood vessels. It has been observed not only that it reduces blood pressure, but it also reduce stress and anxiety. It appears to do so through its effects on the hypothalamus-pituitary-adrenal axis.

http://www.ncbi.nlm.nih.gov/pubmed/17514587

Wikipedia mentions concerns that long term use might actually increase the risk of heart attack:

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

(edited to correct spelling)

Title: Re: prophylactic meds
Post by Bob_Johnson on Feb 19^th, 2008, 8:11pm

No hits using with Cluster but showing some interesting results with migraine. In time we will see some trials, I expect.

Note corrected spelling.
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Hypertens Res. 2004 Jun;27(6):441-6.Related Articles, Links
Efficacy of candesartan in the treatment of migraine in hypertensive patients.

Owada K.

Department of Internal Medicine, Aoyama Hospital, Tokyo, Japan. 1730nuro@tmd.ac.jp

Triptans are usually administered for migraine, but cannot be given to patients with malfunctioning cardiac or cerebral vascular systems, which commonly accompany hypertension. This article focuses on 8 cases in which treatment with candesartan was successful in reducing both the incidence and severity of headache in hypertensive patients with migraine. The cases reported in this article showed a mean improvement in Migraine Disability Assessment score from 29.4 to 9 points and in blood pressure from 154.9/90.4 to 129.5/81.9mmHg, suggesting that candesartan is an extremely attractive option for the treatment of migraine. Although recent studies have reported the efficacy of candesartan for treating migraine, there has been no description of its potential advantages over other prophylactic drugs. The present study included patients who could not tolerate triptans for whom triptans were contraindicated, several patients for whom other migraine prophylactic drugs showed little or no effect, and one patient for whom candesartan was prescribed initially for hypertension, but was also found to be therapeutic for migraines. Thus candesartan is considered to be a unique, attractive choice of prophylactic agent for migraine complicated by hypertension.

Publication Types:
Case Reports

PMID: 15253110 [PubMed - indexed for MEDLINE]

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3: Curr Opin Neurol. 2003 Jun;16(3):341-5.Related Articles, Links
The evolving management of migraine.

Ashkenazi A, Silberstein SD.

Jefferson Headache Center, Department of Neurology, Thomas Jefferson University Hospital, Gibbon Building, Suite #8130, 111 South Eleventh Street, Philadelphia, PA 19107, USA.

PURPOSE OF REVIEW: To review recent advances in acute and preventive migraine treatment. RECENT FINDINGS: The number of migraine drugs continues to expand, allowing for more flexible and tolerable treatment plans. Two new triptans, frovatriptan and eletriptan, and a nasal formulation of zolmitriptan have been recently developed. Eletriptan is effective for acute migraine treatment and may have some pharmacologic and clinical advantages. Frovatriptan has a longer half-life and lower headache recurrence rates compared with other triptans. It may be useful for patients who have prolonged attacks and high headache recurrence rate. Zolmitriptan nasal spray has a rapid onset of action and high efficacy. It should be considered when patients have rapid-onset attacks, especially when associated with severe nausea or vomiting. The butyrophenone neuroleptic droperidol is very effective in aborting acute migraine attacks. Central nervous system side effects are common, however, and the ECG should be monitored. Botulinum toxin type A shows promise as a safe, tolerable and effective drug for migraine prevention, with the unique advantages of almost no systemic adverse events and a long interval between treatments. The anticonvulsant topiramate is effective for migraine prevention. Cognitive side effects are of less concern with the lower doses needed for migraine. The angiotensin converting enzyme receptor blocker candesartan appears to be effective and highly tolerable in the prevention of migraine, but needs to be further evaluated. SUMMARY: New drugs expand the spectrum of migraine treatment both for the acute attack and for prevention.

Publication Types:
Review

PMID: 12858071 [PubMed

Title: Re: prophylactic meds
Post by Gator on Feb 19^th, 2008, 10:23pm

The retail name for this drug is Atacand. Svenn was involved in a trial with it and had pretty good success with it for a while. Not sure if he is still taking it. I tried it for over two months at 16mg and at 32mg and found no relief, but then nothing else has worked, either, so no big shock there.