Cyclandelate in the Prophylaxis of Migraine: A Placebo-Controlled Study

Hc, Diener; Krupp, P.; Schmitt, Thomas M.; Steitz, G; Milde, Katarzyna; Freytag, Saskia

doi:10.1046/j.1468-2982.2001.00153.x

Cited by 30 publications

(13 citation statements)

References 8 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The first study showed cyclandelate to be no more effective than placebo in reducing migraine days, attacks, or duration. 35 The second study (smaller, underpowered; n ϭ 25) found cyclandelate significantly reduced the number of migraine days and duration (assessed using a contingent negative variation measure). 36 Conclusions.…”

mentioning

confidence: 99%

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

View full text Add to dashboard Cite

Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention? Methods:The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention. Results and Recommendations:The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A). Neurology Epidemiologic studies suggest approximately 38% of migraineurs need preventive therapy, but only 3%-13% currently use it.1 In 2000, the American Academy of Neurology (AAN) published guidelines for migraine prevention.2,3 Since then, new clinical studies have been published on the efficacy and safety of migraine preventive therapies. This guideline seeks to assess this new evidence to answer the following clinical question: For patients with migraine, which pharmacologic therapies are proven effective for prevention, as measured by reduced migraine attack frequency, reduced number of migraine days, or reduced attack severity? This article addresses the safety and efficacy of pharmacologic therapies for migraine prevention.Separate guidelines are available for botulinum toxin. 4 The 2008 guideline included a Level B recommendation that botulinum toxin was probably ineffective for treatment of episodic migraine. A new guideline is in development. An updated guideline on nonsteroidal anti-inflammatory drugs 5 and complementary alternative treatments has been approved for publication as a companion to this guideline. 5 DESCRIPTION OF THE ANALYTIC PROCESSThe AAN and the American Headache Society participated in the development process. An author panel of headache and methodologic experts was assembled to review the evidence. Computerized searches of the MEDLINE, PsycINFO, and CINAHL databases identified new studies (published in English). The search strategy used the MeSH term "headache" (exploded) and a published search strategy for identifying randomized controlled trials ( Appendices e-1-e-5, reference e1, and tables e-1 and e-2 are available on the Neurology Web site at www.neurology.org.

show abstract

mentioning

confidence: 99%

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

View full text Add to dashboard Cite

show abstract

“…This result suggests that the response rate for placebo is lower in migraine prophylaxis than in the acute treatment of migraine attacks. Further studies published subsequently have shown placebo response rates of 14–21% for valproic acid (31, 32), 16% for magnesium (33), 22% for bisoprolol (34) and 31% for propranolol (35). A recent meta‐analysis of 32 studies has found a placebo responder rate of 21%.…”

Section: Placebo Effect In the Prophylactic Treatment Of Headachementioning

confidence: 99%

The Importance of Placebo in Headache Research

Bingel

et al. 2008

Cephalalgia

102

View full text Add to dashboard Cite

The best way to appreciate the efficacy of drug and behavioural therapy in the acute and prophylactic treatment of headache is to perform placebo-controlled randomized trials. In order to plan and conduct these studies in the most appropriate way, it is desirable to know which factors influence the placebo response. This paper reviews factors which influence the placebo response in clinical trials, such as expectation, blinding, route of application of drugs and age, gender and geographical distribution. Response rates of placebo in the treatment of acute headache episodes are higher than in headache prophylaxis. Invasive procedures such as injections have a higher placebo response compared with oral drugs. Variables known to influence the placebo response have to be taken into consideration to calculate properly the power of planned randomized trials.

show abstract

“…A substantial placebo response (37.5% responder rate) was observed in this study. Other studies of prophylactic treatment of migraine demonstrate variable and sometimes marked placebo responses [18][19][20][21][22][23] ranging from a mean frequency reduction observed after treatment with placebo of -6.8% (ie, an increase in frequency of 6.8%) to 38.6%. Different end points, study designs, and patient populations likely contribute to this variability.…”

Section: Discussionmentioning

confidence: 99%