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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> Histamine Desensitization
        
(Message started by: unsolved1 on Sep 10^th, 2004, 7:38pm)

Title: Histamine Desensitization
Post by unsolved1 on Sep 10^th, 2004, 7:38pm

Don't know much about this.

Would you believe me if I said that Dr. Diamond was at my local neuro's office today in southern Indiana ?? Well...she was !!

Doctor Merle Diamond (http://www.diamondheadache.com/staff/mdiamond.html)from the Diamond Headache Clinic said that in patients with chronic cluster headaches ... Histamine Desensitization had about a 60% success rate at aborting and ending the chronic cycle.

Wanting some comments / more information on this IV infusion procedure.

PS. I might be headed for Chicago ???

Unsolved

Title: Re: Histamine Desensitization
Post by chuck on Sep 10^th, 2004, 7:52pm

Ah, finally something I can talk about. I live near Chicago and was a regular at the diamond clinic for a while. I did my first IV histimine treatment around 1997 and my second in 2002. FOR ME it didn't work either time. It was a little vacation though, about 10 days on the floor. You're usually the only Cluster head stuck with a BUNCH of Migraines wearing sunglasses trying to tell you that what they have is the same. I just stayed in my room and kept the Histimines pumping. You go through 21 bags through an IV drip and if you go too fast you'll get a ha, no different than alcohol or Nitro-glycerin. Anyway, it cost me a lot and didn't work, but it has to have worked for SOMEONE!!!! I'm one of those naive people that think that if someone says it then It must be so. Say hi to Merle for me!!!

Title: Re: Histamine Desensitization
Post by don on Sep 10^th, 2004, 8:26pm

Quote:

Anyway, it cost me a lot and didn't work

Someone should hang that sign outside the Diamond clinic.

Title: Re: Histamine Desensitization
Post by IndianaJohn on Sep 11^th, 2004, 9:36pm

I haven't heard anything good about the Diamond HA Clinic in treating CH. I even posted a thread, when my dufus GP wanted to send me there, asking about it.

Title: Re: Histamine Desensitization
Post by Lizzie2 on Sep 11^th, 2004, 9:46pm

From the following journal article:

1 Cluster headache.
Freitag FG - Prim Care - 01-JUN-2004; 31(2): 313-29, vi
From NIH/NLM MEDLINE

Quote:

Histamine desensitization

At the Diamond Headache Clinic, we have had outstanding success with the use of intravenous histamine desensitization in aiding the treatment of patients with chronic cluster headache that has become refractive to treatment. The use of intravenous histamine desensitization in the treatment of cluster headache has been used since the 1930s, when it was developed by Bayard Horton, MD at Mayo Clinic [3] . Review of his case reports and description of cluster headache [4] has been noted to be of such clarity as to have allowed inclusion of patients with other than cluster headache unlikely. Over his years at Mayo, Horton treated approximately 184 patients with histamine between 1936 and 1940 [76] . Of these, 63 patients met most of the clinical features for what he was then calling ?histaminic cephalgia.? Twelve of the 63 cases, however, had some atypical features to their presentation. Of the 51 cases meeting all the criteria, 48 demonstrated relief from chronic cluster headaches with intravenous histamine desensitization for variable periods, most of whom developed a prolonged remission from their attacks. Other headache experts [77] [78] [79] , including Blumenthal [77] and Ryan [79] , who were fellows under Horton, had high rates of success with intravenous histamine desensitization therapy in the treatment of chronic cluster headache. Kunkle et al [2] reported on 30 patients; 11 had received histamine treatments elsewhere without success, though he never used the treatment himself for his patients. Subsequently, Friedman and Mikropouolos [80] reported only 15% of 35 patients as benefiting from histamine desensitization. Like Kunkle, the treatment with histamine was performed elsewhere, they apparently not utilizing it. These later anecdotal reports led to histamine desensitization falling into disrepute in following years by the neurology community. The author has reported previous studies [81] [82] of intravenous histamine desensitization as part of the treatment of intractable cluster headache that had failed to respond to traditional medical therapies for cluster headache. Both of these initial reports showed marked clinical improvement in patients with chronic cluster headache that had become refractive to standard medical therapy. Most recently, the author has been able to demonstrate a superior response from intravenous histamine compared with intravenous repetitive doses of dihydroergotamine (Fred Freitag, DO, unpublished data, 2001). The author also was able to show aspects of the patient with chronic cluster headache and previous treatment that would be helpful in determining who might require only more standard medical therapy versus the patient who would benefit from intravenous histamine desensitization.

The mechanism by which intravenous histamine desensitization may act in cluster headache treatment has not been determined. Exposure of neural origin cells to increasing concentrations of histamine, however, has been shown to inhibit the production of cyclic guanosine 3?,5? monophosphate (cGMP) [83] . They also demonstrated that this was not a calcium-dependent phenomenon, suggesting that it was not related to the formation of cGMP. Increased cGMP activity correlates with increase in the formation of nitric oxide (NO) by way of nitric oxide synthetase (NOS) [84] . Though not studied in cluster headache, this system of cellular mediation has been linked to chronic daily headache and migraine [85] [86] [87] [88] . Patients with cluster headache have been found to have higher levels of plasma nitrites than control subjects [89] , suggesting that this system may be activated even between attacks, thus predisposing patients to their cluster headache attacks. These studies suggest that histamine desensitization may be an active agent in the prevention of cluster headache by downregulating the cGMP-NO-L-arginine pathway by the persisting high levels of histamine present during the treatment process.