Opioids

Silberstein, SD; McCrory, DC

doi:10.1046/j.1468-2982.2000.00149.x

Cited by 14 publications

(9 citation statements)

References 38 publications

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“…Opioid receptor agonists, such as morphine, codeine and pethidine (meperidine), have been used for many years to treat all forms of headache, including migraine (Gowers, 1888; Ziegler, 1997). Simple and effective for some headaches, even favoured in some settings (Silberstein & McCrory, 2000), detailed studies of the possible loci of action of opiate receptor agonists in primary headaches have not been conducted. Studies of the action of opioids in headache may increase understanding of their clinical role in these disorders.…”

Section: Introductionmentioning

confidence: 99%

Characterization of opioid receptors that modulate nociceptive neurotransmission in the trigeminocervical complex

Storer

Akerman

Goadsby

2003

British J Pharmacology

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1 Opioid agonists have been used for many years to treat all forms of headache, including migraine. We sought to characterize opioid receptors involved in craniovascular nociceptive pathways by in vivo microiontophoresis of m-receptor agonists and antagonists onto neurons in the trigeminocervical complex of the cat. 2 Cats were anaesthetized with a-chloralose 60 mg kg 71 , i.p. and 20 mg kg 71 , i.v. supplements after induction and surgical preparation using halothane. Units were identi®ed in the trigeminocervical complex responding to supramaximal electrical stimulation of the superior sagittal sinus, and extracellular recordings of activity made. 3 Seven-or nine-barrelled glass micropipettes incorporating tungsten recording electrodes in their centre barrels were used for microiontophoresis of test substances onto cell bodies. 4 Superior sagittal sinus (SSS)-linked cells whose ®ring was evoked by microiontophoretic application of L-glutamate (n=8 cells) were reversibly inhibited by microiontophoresis of H 2 N-Tyr-D-Ala-Gly-N-Me-Phe-Gly-ol (DAMGO) (n=12), a selective m-receptor agonist, in a dose dependent manner, but not by control ejection of sodium or chloride ions from a barrel containing saline. 5 The inhibition by DAMGO of SSS-linked neurons activated with L-glutamate could be antagonized by microiontophoresis of selective m-receptor antagonists D-Phe-Cys-Tyr-D-Trp-OrnThr-Pen-Thr-NH 2 (CTOP) or D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH 2 (CTAP), or both, in all cells tested (n=4 and 6, respectively). 6 Local iontophoresis of DAMGO during stimulation of the superior sagittal sinus resulted in a reduction in SSS-evoked activity. This e ect was substantially reversed 10 min after cessation of iontophoresis. The e ect of DAMGO was markedly inhibited by co-iontophoresis of CTAP. 7 Thus, we found that m-receptors modulate nociceptive input to the trigeminocervical complex. Characterizing the sub-types of opioid receptors that in¯uence trigeminovascular nociceptive transmission is an important component to understanding the pharmacology of this synapse, which is pivotal in primary neurovascular headache.

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Section: Introductionmentioning

confidence: 99%

Characterization of opioid receptors that modulate nociceptive neurotransmission in the trigeminocervical complex

Storer

Akerman

Goadsby

2003

British J Pharmacology

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“…Opioids are used in the USA to treat a variety of pain conditions ranging from cancer pain to musculoskeletal pain and headache. 8,9 According to the American Academy of Neurology Practice Parameter, opioids are considered second-or third-tier treatments for migraine following simple analgesics and migraine-specific medications. 6 However, some persons with migraine may have contraindications (eg, pregnancy and cardiovascular disease [CVD]), problems with tolerability, or lack of response to simple analgesics or migraine-specific medications.…”

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confidence: 99%

Opioid Use and Dependence Among Persons With Migraine: Results of the AMPP Study

et al. 2012

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“…Opioids are increasingly accepted as appropriate therapy for patients not responding to other interventions among headache specialists. 12 It was, therefore, somewhat surprising to see that about ten percent of the pain specialist respondents to this survey considered opioids contraindicated for chronic headache management. Conversely, there is no consensus about the role of opioids in fibromyalgia although many clinicians report anecdotally that some fibromyalgia patients do function better on low dose, chronic opioid therapy.…”

Section: Discussionmentioning

confidence: 95%

Clinician Beliefs About Opioid Use and Barriers in Chronic Nonmalignant Pain

Grahmann

Jackson

Lipman

2004

J. Of Pain & Palliative Care Pharmacotherapy

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A survey of the medical directors of multidisciplinary pain clinics and multidisciplinary pain centers listed in the American Pain Society Pain Facilities Directory was conducted to define those pain specialists' beliefs about the role of opioid analgesia in 14 types of chronic nonmalignant pain. Respondents also reported their perceptions of barriers to their prescribing opioids for chronic nonmalignant pain and what they perceived as barriers to opioid prescribing for chronic nonmalignant pain by other, non-pain specialist clinicians in their communities. The respondents are characterized by demographics, disciplines, specialties, and time in practice. The percentage of time that a pharmacist was available in the pain programs also is reported. There is increasing acceptance of opioids for most of the listed types of chronic nonmalignant pain, but the acceptance varies by types of pain syndromes. Opioids were most consistently accepted for sickle cell disease pain and least commonly endorsed for headaches, myofascial pain, and fibromyalgia. Factors that may influence clinicians' perceptions about opioids are discussed.

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Opioids

Cited by 14 publications

References 38 publications

Characterization of opioid receptors that modulate nociceptive neurotransmission in the trigeminocervical complex

Characterization of opioid receptors that modulate nociceptive neurotransmission in the trigeminocervical complex

Opioid Use and Dependence Among Persons With Migraine: Results of the AMPP Study

Clinician Beliefs About Opioid Use and Barriers in Chronic Nonmalignant Pain

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