Role of antihypertensive drugs in the treatment of migraine

Fehér, Gergely; Pusch, Gabriella

doi:10.1556/oh.2015.30056

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…topiramate) (7,8), β-blockers (e.g. propranolol) (9), calcium channel blockers (10,11) and onabotulinum toxin A (12). In many patients, these drugs are associated with limited efficacy and numerous undesirable side effects (for review, see (4)).…”

Section: Introductionmentioning

confidence: 99%

Kappa opioid receptor antagonists: A possible new class of therapeutics for migraine prevention

et al. 2017

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Background: Stress is the most commonly reported migraine trigger. Dynorphin, an endogenous opioid peptide acting preferentially at kappa opioid receptors (KORs), is a key mediator of stress responses. The aim of this study was to use an injury-free rat model of functional cephalic pain with features of migraine and medication overuse headache (MOH) to test the possible preventive benefit of KOR blockade on stress-induced cephalic pain. Methods: Following sumatriptan priming to model MOH, rats were hyper-responsive to environmental stress, demonstrating delayed cephalic and extracephalic allodynia and increased levels of CGRP in the jugular blood, consistent with commonly observed clinical outcomes during migraine. Nor-binaltorphimine (nor-BNI), a long-acting KOR antagonist or CYM51317, a novel short-acting KOR antagonist, were given systemically either during sumatriptan priming or immediately before environmental stress challenge. The effects of KOR blockade in the amygdala on stress-induced allodynia was determined by administration of nor-BNI into the right or left central nucleus of the amygdala (CeA). Results: KOR blockade prevented both stress-induced allodynia and increased plasma CGRP. Stress increased dynorphin content and phosphorylated KOR in both the left and right CeA in sumatriptan-primed rats. However, KOR blockade only in the right CeA prevented stress-induced cephalic allodynia as well as extracephalic allodynia, measured in either the right or left hindpaws. U69,593, a KOR agonist, given into the right, but not the left, CeA, produced allodynia selectively in sumatriptan-primed rats. Both stress and U69,593-induced allodynia were prevented by right CeA U0126, a mitogen-activated protein kinase inhibitor, presumably acting downstream of KOR. Conclusions: Our data reveal a novel lateralized KOR circuit that mediated stress-induced cutaneous allodynia and increased plasma CGRP in an injury-free model of functional cephalic pain with features of migraine and medication overuse headache. Selective, small molecule, orally available, and reversible KOR antagonists are currently in development and may represent a novel class of preventive therapeutics for migraine.

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Section: Introductionmentioning

confidence: 99%

Kappa opioid receptor antagonists: A possible new class of therapeutics for migraine prevention

et al. 2017

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“…Anti-HT agents can be divided into groups, including renin-angiotensin-converting enzyme inhibitors, beta blockers, calcium channel blockers, and diuretics [30]. Various anti-HT drugs (ACE-inhibitors and angiotensin receptor blockers) are used for treating migraine [31]. Differences in the effect of different groups of anti-HTs on headaches and migraine originate from their impact on vascular tonus in peripheral and cerebrovascular circulation [32].…”

Section: Discussionmentioning

confidence: 99%

Effect of Hypertension on Pain Threshold in Patients With Chronic Pain

Koca¹,

Aykan²,

Berk³

et al. 2023

CAJMHE

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Introduction: Little is known about the relationship between pain and hypertension (HT). This study aimed to analyze the effect of HT on pain sensitivity in patients with chronic musculoskeletal pain complaints. Methods: This analytical, cross-sectional study included 45 patients aged 29–75 years with HT. The control group comprised 44 normo/hypotensive patients aged 19–66 (P = 0.107). Education status, age, gender, height, weight, smoking, presence of diabetes mellitus, physical activity level, blood pressure measurement, anti-HT drug use, vital parameters, including heart rate, respiratory rate, and body temperature, were recorded for all participants. Results: The pain score was significantly higher in the HT group, with a mean of 72.1 ± 30.2 points (P = 0.008). Also, the HT group’s systolic blood pressure and pain score were significantly positively correlated (rho = 0.245, P = 0.02). The pulse rate was found to be significantly related to the pain score and pain threshold (P < 0.001); it was negatively correlated with algometer values (rho = –0.286, P = 0.015). Systolic pressure (P = 0.033) and BMI ( P < 0.001) were significantly different among the groups according to physical activity level. The Spearman correlation analysis showed a positive correlation of diastolic blood pressure with the body mass index (rho = 0.224, P = 0.036) and pain score (rho = 0.456, P < 0.001). Conclusion: The present study showed that the pain complaint increases as the blood pressure and weight increase. Also, the pain threshold decreases as the heart rate increases. The pain threshold was lower in women than in men, independent of tension.

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Pharmacologic Approaches to CDH: Evidence and Outcomes

Láinez

Mínguez‐Olaondo

2018

Chronic Headache

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Role of antihypertensive drugs in the treatment of migraine

Cited by 3 publications

References 29 publications

Kappa opioid receptor antagonists: A possible new class of therapeutics for migraine prevention

Kappa opioid receptor antagonists: A possible new class of therapeutics for migraine prevention

Effect of Hypertension on Pain Threshold in Patients With Chronic Pain

Pharmacologic Approaches to CDH: Evidence and Outcomes

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