Transient Hypnic Headache Syndrome in a Patient With Bipolar Disorder After the Withdrawal of Long-Term Lithium Treatment: A Case Report

Karlovasitou, Anna; Avdelidi, Eugenia; Andriopoulou, G.; Baloyannis, Stavros

doi:10.1111/j.1468-2982.2008.01758.x

Cited by 22 publications

(12 citation statements)

References 13 publications

(22 reference statements)

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“…Side effects include tremor, diarrhoea, increased thirst and polyuria. Recently, a transient HH was described in a patient with bipolar disorder after the withdrawal of long-term lithium treatment [34]. Many other agents that have been reported to effectively treat HH include bedtime doses of caffeine (40–60 mg tablet, or as a cup of coffee), indomethacin, flunarizine, tricyclic antidepressants, verapamil, prednisone, topiramate, gabapentin, melatonin, benzodiazepines, pregabalin and acetazolamide.…”

Section: Treatmentmentioning

confidence: 99%

Focus on therapy of hypnic headache

Lisotto¹,

Rossi²,

Tassorelli

et al. 2010

J Headache Pain

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Hypnic headache (HH) is a primary headache disorder, which occurs exclusively during sleep and usually begins after 50 years of age. There are no controlled trials for the treatment of HH. We reviewed all the available papers, including 119 cases published in literature up to date, reporting the efficacy of the medications used to treat HH. Acute treatment is not recommended, since no drug proved to be clearly effective and also because the intensity and the duration of the attacks do not require the intake of a medication in most cases. As for prevention, a wide variety of medications were reported to be of benefit in HH. The drugs that were found to be effective in at least five cases are: lithium, indomethacin, caffeine and flunarizine. Lithium was the most extensively studied compound and demonstrated to be an efficacious treatment in 32 cases. Unfortunately, despite its efficacy, significant adverse effects and poor tolerability are not rare, mainly in elderly patients. Many patients reported a good response to indomethacin, but some could not tolerate it. Caffeine and melatonin treatments did not yield robust evidence to recommend their use as single preventive agents. Nevertheless, their association with lithium or indomethacin seems to produce an additional therapeutic efficacy. A course of lithium should be tried first, followed 3–4 months later by tapering. If headache recurs during tapering, a longer duration of therapy may be needed. If lithium treatment does not provide a significant response, indomethacin can be commenced as second-line approach. If these treatments prove to be ineffective or poorly tolerated, other agents, such as caffeine and melatonin, can be administered.

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Section: Treatmentmentioning

confidence: 99%

Focus on therapy of hypnic headache

Lisotto¹,

Rossi²,

Tassorelli

et al. 2010

J Headache Pain

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“… Most of the literature on this form of headache is from case reports; secondary causes of headache must be excluded in these patients, and brain imaging is generally recommended for evaluation of brainstem or posterior fossa lesions . Head pain resembling the hypnic headache phenotype has been reported with medication overuse and withdrawal from angiotensin‐converting enzyme inhibitors and lithium . Nocturnal hypertension is another differential diagnosis to be considered and may require 24‐hour ambulatory blood pressure monitoring …”

Section: Headache Diagnosesmentioning

confidence: 99%

“…24 Head pain resembling the hypnic headache phenotype has been reported with medication overuse 25 and withdrawal from angiotensin-converting enzyme inhibitors 26 and lithium. 27 Nocturnal hypertension is another differential diagnosis to be considered and may require 24-hour ambulatory blood pressure monitoring. 28…”

Section: Hypnic Headachementioning

confidence: 99%

Diagnosis and Treatment of Primary Headache Disorders in Older Adults

Berk

Ashina

Martin

et al. 2018

J American Geriatrics Society

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Objectives To provide a unique perspective on geriatric headache and a number of novel treatment options that are not well known outside of the headache literature. Design Review of the most current and relevant headache literature for practitioners specializing in geriatric care. Results Evaluation and management of headache disorders in older adults requires an understanding of the underlying pathophysiology and how it relates to age‐related physiological changes. To treat headache disorders in general, the appropriate diagnosis must first be established, and treatment of headaches in elderly adults poses unique challenges, including potential polypharmacy, medical comorbidities, and physiological changes associated with aging. Conclusion The purpose of this review is to provide a guide to and perspective on the challenges inherent in treating headaches in older adults. J Am Geriatr Soc 66:2408–2416, 2018.

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“…By contrast, obstructive sleep apnea syndrome has to be ruled out only if HH patients have additional symptoms such as excessive daytime sleepiness, fatigue, and unintentional sleep episodes during wakefulness . Finally, a drug withdrawal should be ruled out, since HH has been reported in case reports after angiotensin‐converting enzyme inhibitor withdrawal or lithium withdrawal and associated with medication overuse.…”

Section: Diagnosis – New Criteria Proposed By Ichd‐3βmentioning

confidence: 99%