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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Viagra & Ginseng as Triggers
        
(Message started by: floridian on Aug 24^th, 2003, 10:12am)

Title: Viagra & Ginseng as Triggers
Post by floridian on Aug 24^th, 2003, 10:12am

Wanted to open a thread about Viagra and Ginseng as triggers. Anyone have any experience? A search of this board gave 15 articles mentioning viagra, predictably, most was humor related.

Both ginseng and viagra enhance nitric oxide activity. The research on alcohol as a trigger repeatedly refers to nitric oxide. The one cluster I have had this year (out of cycle) was after taking ginseng (no experience with viagra).

One message from 1999 asked if viagra was a trigger, but didn't know that viagra boosts nitric oxide:
http://www.clusterheadaches.com/wwwboard/messages/23777.html

Pubmed summary:

viagra and "nitric oxide" 156 articles
viagra and migraine 2 articles
viagra and "cluster headache" 0 articles
ginseng and "nitric oxide" 42 articles
ginseng and "cluster headache" 0 articles

Viagra information lists migraine as a "rare" side effect (http://sildenafil.com/side_effects.html) but not a counterindication.

From Pfizer (www.pfizer.com/download/uspi_viagra.pdf )
Mechanism of Action The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.

Migraine can be induced by sildenafil without changes in middle cerebral artery diameter.

Kruuse C, Thomsen LL, Birk S, Olesen J.

Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Copenhagen, Denmark. ckruuse@dadlnet.dk

Migraine is considered a neurovascular disease involving dilatation of cerebral arteries. Nitric oxide (NO) donors induce dilatation of cerebral and extracranial arteries and migraine, but NO has several mechanisms of action in addition to its cyclic guanosine monophosphate (cGMP)-mediated vasodilatation. We examined whether sildenafil (Viagra), a selective inhibitor of cGMP-hydrolysing phosphodiesterase 5 (PDE5), which acts exclusively by increasing cGMP, can induce migraine and dilatation of cerebral arteries. We included 12 patients with migraine without aura in this double-blind, placebo-controlled crossover study, in which placebo or sildenafil 100 mg was administered orally on two separate days. Blood flow velocity in the middle cerebral artery (V(mca)) was recorded by transcranial Doppler ultrasonography and regional cerebral blood flow in the territory of the middle cerebral artery (rCBF(mca)) was measured using SPECT (single photon emission computed tomography) and xenon 133 inhalation. Radial and temporal artery diameters were studied using high-frequency ultrasonography. Headache response, tenderness of pericranial muscles, blood pressure and heart rate were measured repeatedly. We found that migraine attack was induced by sildenafil in 10 of 12 migraine patients and by placebo in two of 12 patients (P = 0.01). V(mca) (P = 0.1) and rCBF(mca) (P = 0.93) remained unchanged after sildenafil. Temporal (P = 0.47) and radial (P = 0.87) artery diameter and pericranial tenderness (P = 0.16) were unaffected by sildenafil. Systolic and diastolic blood pressures were unchanged but heart rate increased from a mean of 62 +/- 2 to 74 +/- 3 beats/min (P = 0.01) after sildenafil. Our results demonstrate that migraine may be induced via a cGMP-dependent mechanism, and we show for the first time that this occurs without initial dilatation of the middle cerebral artery. We propose that triggering mechanisms may reside within the perivascular sensory nerve terminals or the brainstem. However, other sites of action may also be possible and future studies are needed to elucidate this. In the clinical use of sildenafil, patients who have migraine should be informed about the risk of migraine attacks.

Title: Re: Viagra & Ginseng as Triggers
Post by brewcrew on Aug 24^th, 2003, 11:03am

Yep. Took Viagra once while in cycle. Never again! Seems to make sense. Our problem as cluster sufferers is that we can't constrict the blood vessels in our head fast enough. Viagra has the opposite effect - dialation. It triggered one of the worst headaches I've ever experienced, although oxygen brought it under control very quickly.

"Not tonight, dear. I might get a headache." LOL!

Title: Re: Viagra & Ginseng as Triggers
Post by jmorgan52 on Aug 25^th, 2003, 9:32am

So viagra is the cause of these "fucking headaches" ;D

Not tried it yet, honest. But from what I have read I already deduced what brew found out from experience :-/ about the dilation/constriction issue.