Posted by Miguel (209.42.249.112) on March 29, 2000 at 09:00:34:
In Reply to: triptans posted by Lawrence Robbins M.D. on March 28, 2000 at 20:22:01:
Larry:
Thank you for your kind listing of drugs, effects
and efficacy (along with a shameless plug for your
book). Although I have been lurking this board
for much shorter time than some, I feel that
most people here are very much aware of the available
medications in the market, their effects, and
undesirable side effects. Believe me when I tell
you that when one suffers one of these attacks the
incentive is there to do some serious reading of
available literature on all aspects of headaches,
medications, etc.
Perhaps far more useful would be to outline what
specific progress have been made in relation to
any finding any connections between CH and other
CNS problems i.e: physio-psychological, any connection
between depression, psycosis, epilepsy and CH?
What is the role of MAO inhibitors in CH? Has that
relationship been studied? Why it seems to be a
trend to prescribe Neurontin, but rarely Lamotrigine
as adjuncts to CH management now-a-days? How is
5-HT receptor subtype-drug interaction involved in
CH? Is there a specific 5-HT receptor subtype involved
in CH? Why is LSD apparently very effective in
stopping CH cycles, but Sansert, an analog of LSD,
rarely effective in doing so? What is the specific
interaction between receptor and agent in the LSD
case? Is it ireversible, although hallucinogenic
side effects cease to be present? Does such conduct
to a receptor blocking intereaction with a supposed
desensitization to the drug effects?
There appears to be a hormonal relationship with CH.
What is being done to elucidate the specifics of
such interaction? What is the involvement of the
hypothalamus (the new buzz hype) in CH? Is the
pituitary gland involved in CH? What advances are
there in myelin sheath damage, intra-vascular wall
transport of ions and CH relationships? Does
platelet aggreagation play a role in CH? Is PGI2
involved in CH? If so how? Why is arachnidonic acid
involved in CH, yet aspirin is not effective in
managing the ailment?
Just a few of the top of my head. I appreciate any
response :)
Miguel