Treatment of Migraines

Among the indole derivatives which have found use as drugs are indo-methacin, one of the first non-steroidal anti-inflammatory agentsfll], sumatriptan, which is used in the treatment of migraine headaches[12] and pindolol[13], one of the p-adrenergic blockers. 

Destmction of the aluminum complex with ammonia then permits hydrocarbon extraction of the alkaloid. The alkaloid is subsequently both isolated and used as its tartrate salt. This nonnarcotic dmg, for which tolerance may develop, is frequently used orally with caffeine (16) for treatment of migraine it acts to constrict cerebral blood vessels, thus reducing blood flow to the brain. 

Imitrex (Sumatriptan) 82 is the first selective 5-HTid agonist developed by Glaxo for the treatment of migraine. The synthesis of Imitrex has been carried out by several different routes all of which involved a Fischer indolization reaction as the key step. Outlined below is one of the synthetic routes. 

Clinical trial evidence supports many NSAID medications in the acute treatment of migraines with and without aura.30 The currently marketed cyclooxygenase-2 (COX-2) selective... 

Lewis D, Ashwal S, Hershey A, et al. Practice parameter Pharmacological treatment of migraine headache in children and adolescents. Report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology 2004 63 2215-2224. 

Acute Treatment of Migraine Subcutaneous Placebos Are Better Than Oral Placebos , Journal of Neurology 247 (2000) 183-88 Delgado, Pedro L., Depression The Case for a Monoamine Deficiency , Journal of Clinical Psychiatry 61 (2000) 7-11 Depression Drugs Don t Work, Says New Study , The Times, 26 February 2008... 

CBZ-D-proline 12 Eletriptan Treatment of migraine Hydrolysis Arthrobacter sp. Single-stage fermentation [7]... 

This nonhypnotic barbiturate (proxibarbal, 302) is used as a tranquillizer in the treatment of migraine. It gave a different spectrum of photolysis products from... 

A contact dermatitis occurs infrequently. Because feverfew also inhibits human blood platelet aggregation, interactions are possible with antithrombotic medications such as aspirin or warfarin (Groenewegen and Heptinstall 1990). Abrupt discontinuation of feverfew by people taking it chronically for treatment of migraine can produce rebound withdrawal symptoms. These consist of migraines, anxiety, poor sleep patterns, and stiffness of the muscles and joints. 

The early suggestion by Fozard [54] that 5-HT3 receptor antagonists may be useful in the treatment of migraine has yet to be established, although MDL 72222 appeared to be effective in limited clinical trials [94, 95]. There are exciting prospects for other clinical applications of 5-HT3 antagonists in psychiatric disorders which have been predicted from behavioural studies in rodents and primates, and several clinical trials are underway in psychiatric patients. 

Ergotamine is an ergot alkaloid indicated in the treatment of migraine. Ergotamine has marked vasoconstrictor effects. 

Sumatriptan is a 5HT (serotonin) agonist indicated in the treatment of migraine. Sumatriptan causes vasoconstriction and must therefore be used with caution in patients with coronary heart disease, such as angina. Concurrent administration of the agonist, sumatriptan and antagonists, such as fluoxetine, which is a selective serotonin re-uptake inhibitor, leads to increased CNS toxicity. 

Ergotamine is an ergot derivative indicated for the treatment of migraine. Amitriptyline and propranolol can be used for the prophylaxis of migraine. 

Any migraine sufferer will willingly testify that this condition has little in common with the headaches to which the rest of mankind are subject. Recent medical studies too have shown fairly conclusively that, whatever the etiology of migraine, it is a condition quite distinct from the common headache. The syndrome is in fact so distinct as to be untouchable by the common headache cures such as aspirin. Drugs for treatment of migraine are unfortunately almost nonexistent. (The lack of appropriate animal models in no small way hinders the search for a treatment.) A... 

Migraine Acute treatment of migraine attacks with or without aura. 

ALMOTRIPTAN Doses of 6.25 and 12.5 mg were effective for the acute treatment of migraines in adults, with the 12.5 mg dose tending to be a more effective dose. Individuals may vary in response to doses of almotriptan therefore, individualize the dosage. 

RIZATRIPTAN Single doses of 5 and 10 mg were effective for the acute treatment of migraines in adults. There is little evidence that the 10 mg dose may provide a greater effect than the 5 mg dose. The choice of dose should be made on an individual basis, weighing the possible benefit of the 10 mg dose with the potential risk for increased adverse events. 

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