Tolfenamic Acid, Metoclopramide, Caffeine and Their Combinations in The Treatment of Migraine Attacks

Cephalalgia ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 253-263 ◽  
Author(s):  
Riitta A Tokola ◽  
Pentti Kangasniemi ◽  
Pertti J Neuvonen ◽  
Olavi Tokola
Keyword(s):  
Side Effects ◽  
Clinical Studies ◽  
Tolfenamic Acid ◽  
Acute Migraine ◽  
Double Blind ◽  
Better Than

Tolfenamic acid is a fenamate which inhibits prostaglandin (PG) biosynthesis and may act as a PG antagonist as well. Caffeine and metoclopramide are used in combination with analgesics and ergotamine in the treatment of migraine attacks, but controlled clinical studies on fixed combinations with analgesics are rare. The effects of orally given tolfenamic acid (200 mg), caffeine (100 mg), metoclopramide (10 mg), tolfenamic acid + caffeine (200 mg + 100 mg), tolfenamic acid + metoclopramide (200 mg + 10 mg) and placebo were studied in 49 migraine patients (3 men, 46 women) in a double-blind randomized cross-over study comprising 482 migraine attacks. The patients were allowed to take either one or two capsules of each preparation for an attack. Additional drugs were allowed after 3 h. Parameters characterizing the effects and side-effects of the drugs were registered. Tolfenamic acid and its combinations were found to be effective in the treatment of acute migraine, but caffeine and metoclopramide alone did not differ from placebo. Combination with metoclopramide was better than tolfenamic acid alone as judged by the smaller dose needed and the intensity of attack. Between tolfenamic acid alone and its caffeine combination there were no statistically significant differences.

Efficacy of Nimodipine in the Prophylaxis of Migraine

Cephalalgia ◽  
1985 ◽  
Vol 5 (1) ◽  
pp. 39-43 ◽  
Author(s):  
H Havanka-Kanniainen ◽  
E Hokkanen ◽  
VV Myllylä
Keyword(s):  
Side Effects ◽  
Drug Treatment ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Final Value ◽  
Prophylactic Drug ◽  
Better Than

The efficacy of nimodipine in the prophylaxis of migraine was assessed in a double-blind, placebo-controlled, cross-over study carried out on 33 patients, 20 of whom suffered from classic and 13 from common migraine. Four patients dropped out, but not as a result of the side effects of the drug. The duration of drug treatment was 8 weeks. The dosage used was 30 mg four times daily. Nimodipine proved to be better than placebo, the number of migraine attacks and severity of headache showing a significant reduction. The drug was well tolerated and no marked side effects were noted. The results suggest that nimodipine is a useful new prophylactic drug for migraine, but further studies are needed before its final value can be evaluated.

A Controlled Trial of Baclofen in Children with Cerebral Palsy

1973 ◽  
Vol 1 (2) ◽  
pp. 398-404 ◽  
Author(s):  
P J Milla ◽  
A D M Jackson
Keyword(s):  
Cerebral Palsy ◽  
Side Effects ◽  
Dose Reduction ◽  
Crossover Trial ◽  
Controlled Trial ◽  
Drug Effects ◽  
Double Blind ◽  
Muscle Spasticity ◽  
Children With Cerebral Palsy ◽  
Better Than

A double-blind crossover trial against placebo was conducted to assess the effects of the GABA derivative, baclofen, on the disabilities due to muscle spasticity in twenty children suffering from cerebral palsy. Baclofen performed very significantly better than placebo in reducing spasticity and significantly better than placebo in allowing both active and passive limb movements to be carried out. Notable improvement was also seen in scissoring. Side-effects were minimal and responded promptly to dose reduction. The evaluation of drug effects on muscle spasticity and the pharmacodynamics of baclofen are discussed. Recommendations are made regarding dosage of baclofen in childhood.

A Clinical Comparison of Triazolam with Placebo and with Secobarbital in Insomniac Patients

1978 ◽  
Vol 6 (4) ◽  
pp. 343-347 ◽  
Author(s):  
K Kay Okawa ◽  
George S Allen
Keyword(s):  
Side Effects ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Questionnaire Data ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Sleep Questionnaire ◽  
Clinical Comparison ◽  
Hypnotic Efficacy ◽  
Better Than

Seventy-six out-patient insomniacs participated in three different two-night, double-blind crossover trials investigating the hypnotic efficacy and safety of triazolam. Triazolam 0.5 mg was compared to placebo in one trial conducted by K Kay Okawa, MD, and triazolam 0.5 mg was compared to secobarbital 100 mg in trials conducted by K Kay Okawa, MD and George S Allen, MD. The results of the latter two studies were combined and the data analyzed jointly. Triazolam 0.5 mg was found to be preferred and to be significantly better than both placebo and secobarbital 100 mg in the treatment of insomnia. Analysis of sleep questionnaire data showed triazolam to be superior to either placebo or secobarbital on the following parameters: how much the medication helped the patient sleep; onset of sleep; duration of sleep; and number of nocturnal awakenings. No differences were observed between treatments in any trial with regard to the patient's feeling of alertness the next morning. The side-effects reported for all treatments did not significantly interfere with the patients' ability to function.

Efficacy of Nimodipine in Comparison with Pizotifen in the Prophylaxis of Migraine

Cephalalgia ◽  
1987 ◽  
Vol 7 (1) ◽  
pp. 7-13 ◽  
Author(s):  
H Havanka-Kanniainen ◽  
E Hokkanen ◽  
V V Myllylä
Keyword(s):  
Side Effects ◽  
Therapeutic Efficacy ◽  
Effective Drug ◽  
Double Blind ◽  
Placebo Period ◽  
Drug Treatments ◽  
Better Than

The efficacy of nimodipine in comparison with that of pizotifen was assessed in the prophylaxis of migraine in a double-blind cross-over study, in which a double-dummy technique was also utilized. The study was carried out on 43 migraine patients, of whom 15 had classic and 28 had common migraine. A 4-week run-in placebo period preceded the drug treatments, the drug treatments lasted 12 weeks, and there was a washout placebo period of 4 weeks between nimodipine and pizotifen treatments. The dosages used were 40 mg three times daily for nimodipine and 0.5 mg three times daily for pizotifen. Both nimodipine and pizotifen proved to be better than placebo, the number of migraine attacks showing a significant reduction. There was no difference between nimodipine. and pizotifen in antimigrainous efficacy, but there were fewer side effects during the nimodipine period. The results suggest that nimodipine is an effective drug for the prophylaxis of migraine, with few side effects and therapeutic efficacy equal to that of pizotifen.

Comparative Efficacy of Lormetazepam (Noctamid®) and Diazepam (Valium®) in 100 Out-Patients with Insomnia

1981 ◽  
Vol 9 (3) ◽  
pp. 199-202 ◽  
Author(s):  
M Sastre y Hernández ◽  
H-D Hentschel ◽  
K Fichte
Keyword(s):  
Side Effects ◽  
Sleep Disorders ◽  
Blind Study ◽  
Double Blind Study ◽  
Comparative Efficacy ◽  
Double Blind ◽  
Better Than

Lormetazepam (Noctamid®) at a dosage of 1 mg was compared with diazepam (Valium®) at a dosage of 5 mg in a 7-day double-blind study. The study involved fifty patients in the lormetazepam group and fifty patients in the diazepam group. All the patients were suffering from sleep disorders as a concomitant symptom of general diseases. Lormetazepam was significantly better than diazepam in the: Reduction of the time taken to fall asleep (p < 0.05) Prolongation of the duration of uninterrupted sleep (p < 0.05) Reduction of the frequency of awakening (p < 0.05) Lormetazepam displayed no hang-over effects or other side-effects and, in this respect too, was significantly superior to diazepam (p < 0.05).

Early clinical experience with subcutaneous GR43175 in acute migraine: An overview

Cephalalgia ◽  
1989 ◽  
Vol 9 (9_suppl) ◽  
pp. 73-77
Author(s):  
P Tfelt-Hansen ◽  
J Brand ◽  
P Dano ◽  
A Doenicke ◽  
LJ Findley ◽  
...  
Keyword(s):  
Side Effects ◽  
Clinical Experience ◽  
Receptor Agonist ◽  
Response Rates ◽  
Acute Migraine ◽  
Double Blind ◽  
Subcutaneous Injections ◽  
Early Clinical Experience ◽  
Dose Ranging ◽  
Blind Trials

In six European clinics 111 migraine patients were treated in a series of open dose-ranging studies with subcutaneous injections of 1 to 4 mg GR43175, a novel 5-HT1-like receptor agonist. Response rates after 20–30 min were dose related and rose from 33% with 1 mg to 96% with 4 mg GR43175. Side effects were minor and transient. These promising results warrant confirmation in placebo-controlled double-blind trials.

Hangover Headache and Prostaglandins: Prophylactic Treatment with Tolfenamic Acid

Cephalalgia ◽  
1983 ◽  
Vol 3 (1) ◽  
pp. 31-36 ◽  
Author(s):  
S. Kaivola ◽  
J. Parantainen ◽  
T. Österman ◽  
H. Timonen
Keyword(s):  
Prophylactic Treatment ◽  
Subjective Evaluation ◽  
Plasma Concentrations ◽  
Drug Efficacy ◽  
Tolfenamic Acid ◽  
Double Blind ◽  
Symptom Scores ◽  
Blood Alcohol Levels ◽  
Hangover Headache ◽  
Better Than

Tolfenamic acid (TA), a potent inhibitor of prostaglandin (PG) biosynthesis and action, was tested prophylactically against hangover symptoms in 30 healthy volunteers in a double–blind cross-over study. One capsule of TA (200 mg) or placebo was taken before starting to drink alcohol and another before going to bed. The hangover symptoms were evaluated in the morning. TA was found significantly better than placebo in the subjective evaluation of drug efficacy ( p<0.001) and in reducing the reported hangover symptoms in general (p < 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p<0.01), and for nausea, vomiting, irritation, tremor, thirst and dryness of mouth (all p < 0.05). In a separate study with eight participants, plasma levels of PGs were followed during ingestion of alcohol with or without TA. The plasma concentrations of PGE2 and TXB2 (a metabolite of thromboxane A2) were lower in the TA group during alcohol ingestion, while PGF2a and 6-keto-PGF1a (a metabolite of prostacyclin) were unaffected. TXB2 correlated with blood alcohol levels in a U-shaped manner.

Tolfenamic Acid and Caffeine: A Useful Combination in Migraine

Cephalalgia ◽  
1982 ◽  
Vol 2 (4) ◽  
pp. 173-177 ◽  
Author(s):  
H. Hakkarainen ◽  
J. Parantainen ◽  
G. Gothoni ◽  
H. Vapaatalo
Keyword(s):  
Potent Inhibitor ◽  
Random Order ◽  
Tolfenamic Acid ◽  
Acute Migraine ◽  
Working Ability ◽  
Prostaglandin Biosynthesis ◽  
Overall Evaluation ◽  
Better Than

Tolfenamic acid is a potent inhibitor of prostaglandin biosynthesis, which has been proved effective in the treatment of acute migraine attacks. The usefulness of caffeine, metoclopramide and pyridoxine as adjuncts to tolfenamic acid was tested in acute migraine attacks in ten patients. A combination of tolfenamic acid (200 mg) with either caffeine (100 mg), metoclopramide (10 mg) or pyridoxine (300 mg) was given twice to each patient in random order. Thus 60 attacks were treated. The tolfenamic acid-caffeine combination proved the most effective as judged by duration and intensity of attacks, working ability, vigilance, and overall evaluation of the drugs by the patients. Metoclopramide was somewhat better than pyridoxine as an additive.

Tolfenamic Acid Decreases Migraine Recurrence When Used with Sumatriptan

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 186-187 ◽  
Author(s):  
AV Krymchantowski ◽  
M Adriano ◽  
D Fernandes
Keyword(s):  
Recurrence Rate ◽  
Prospective Studies ◽  
Acute Treatment ◽  
Tolfenamic Acid ◽  
Effective Drug ◽  
Acute Migraine ◽  
Double Blind ◽  
Double Blind Design

Although sumatriptan is an effective drug for the treatment of acute migraine attacks, recurrence has been cited as an important limitation for its use. Tolfenamic acid is also effective in the acute treatment of migraine attacks. We studied the recurrence rate of migraine attacks with the use of sumatriptan plus tolfenamic acid among patients who presented frequent recurrence with sumatriptan. Fifty migraineurs were retrospectively studied, all having treated at least 10 attacks with 100 mg P.O.; sumatriptan was effective in at least eight of them. The patients also presented recurrence in less than 24 h in at least five of the treated attacks. We then used sumatriptan 100 mg plus tolfenamic acid 200 mg P.O. during the first 60 min of the attack; 240 attacks were treated and there was recurrence in 57 (23.8%). With sumatriptan alone, 5 out of 8 attacks (62.5%) presented recurrence. We therefore conclude that the combination sumatritpan plus tolfenamic acid is effective in reducing the recurrence rate from 5 of 8 (62.5%) to 1.19 of 5 (23.8%). Further prospective studies with a double-blind design and a higher number of treated attacks are necessary to confirm these initial observations.

scholarly journals A Comparison of xylometazoline (Otrivine) and phenylephrine/lignocaine mixture (Cophenylcaine) for the purposes of rigid nasendoscopy: a prospective, double-blind, randomised trial

2008 ◽  
Vol 123 (6) ◽  
pp. 626-630 ◽  
Author(s):  
N A McCluney ◽  
C Y Eng ◽  
M S W Lee ◽  
L G McClymont
Keyword(s):  
Side Effects ◽  
Statistical Methods ◽  
Nasal Spray ◽  
Randomised Trial ◽  
Visual Analogue Score ◽  
Significant Extent ◽  
Double Blind ◽  
To Receive ◽  
Better Than

AbstractObjective:To evaluate if phenylephrine–lignocaine mixture (Cophenylcaine) nasal spray performs better than xylometazoline (Otrivine) spray for the purposes of out-patient rigid nasendoscopy preparation.Design:Prospective, double-blind, randomised trial comparing visual analogue scores for out-patients receiving either phenylephrine–lignocaine mixture or xylometazoline, prior to undergoing rigid nasendoscopy as part of their assessment.Subjects:Seventy-three patients requiring rigid nasendoscopy as part of their assessment were recruited to the study from Raigmore Hospital's out-patient clinic. These patients were randomised to receive a nasal spray comprising either phenylephrine–lignocaine mixture or xylometazoline, 10 minutes prior to rigid nasendoscopy. Double-blinding was adopted. After the procedure, the patient and the doctor independently completed separate visual analogue score-based questionnaires regarding the pain of the procedure and the ease of the examination, respectively.Results:Analysis of the data using standardised statistical methods demonstrated that the phenylephrine–lignocaine mixture did not perform better than xylometazoline, to any statistically significant extent.Conclusion:Phenylephrine–lignocaine mixture is considerably more expensive and has potentially more side effects than xylometazoline. These study findings suggest that it is difficult to justify the use of phenylephrine–lignocaine mixture over xylometazoline, for nasal preparation prior to rigid nasendoscopy.

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