Therapy of Cluster Headache with Histamine H₁ and H₂Receptor Antagonists

Abstract

Treatment with the histamine H₂ receptor antagonist, cimetidine, alone and/or in combination with the histamine H₁ receptor antagonist, chlorpyramine, in 13 patients showed that cimetidine alone was ineffective. 7 of 9 patients taking the combination of H₁ and H₂ receptor antagonists responded well to the treatment; in 1 patient, medication was ineffective and in 1 patient, success was doubtful. In 3 patients with chronic cluster headache, the effect faded after 4 weeks. The results are discussed.

PACAP38- and VIP-induced cluster headache attacks are not associated with changes of plasma CGRP or markers of mast cell activation

“…Plasma CGRP concentrations were determined by radioimmunoassay using antibody AB 4-2905 and α-CGRP as calibrator (16). The tracer was prepared by iodination of [Tyr0] α-CGRP (25–37) amide and purification by high liquid chromatography (HPLC). Samples and calibrators were incubated at 4°C for about 90 h prior to addition of tracer and subsequent incubation for 48 h. Free and antibody-bound tracer were separated by Sac-Cel separation.…”

Possible role of histamine (H1‐ and H2‐) receptors in the regulation of meningeal blood flow

“…histamine was abolished by H 1 ‐receptor antagonist pretreatment (Lassen et al ., 1995). Some clinical studies indicate the role of histamine in cluster headache attacks, since treatment of patients with the combination of H 1 ‐ and H 2 ‐receptor antagonists effectively reduced the intensity and duration of symptoms, but H 2 ‐receptor antagonist pretreatment alone was ineffective (Cuypers et al ., 1979). Other clinical studies could not support the beneficial effect of H 1 ‐ and H 2 ‐receptor antagonist pretreatment in cluster headache patients (Russel, 1979) indicating the complex character of pain generation.…”

Methylergonovine Maleate as a Cluster Headache Prophylactic: A Study and Review

“…Methylergonovine maleate was prescribed as 0.2-mg tablets taken three to four times daily, in addition to concomitant prophylactic medications which included calcium-channel blockers, 26,27 histamine blockers, 28 and/or corticosteroids. 29 In all cases, methylergonovine was added after at least a 1-week trial of more conventional cluster prophylactic medication when patients were still not getting satisfactory relief.…”