Propranolol in the Treatment of Acute Migraine Attacks

Cephalalgia ◽  
1991 ◽  
Vol 11 (4) ◽  
pp. 193-196 ◽  
Author(s):  
Mala Banerjee ◽  
Leslie Findley
Keyword(s):  
Treatment Period ◽  
Crossover Trial ◽  
Double Blind ◽  
Beta Adrenoceptor ◽  
Adrenoceptor Antagonist ◽  
Maximum Period ◽  
Efficacy Assessment ◽  
The Mean ◽  
Acute Attacks ◽  
T Distribution

The efficacy of the beta-adrenoceptor antagonist propranolol in the acute treatment of patients in attacks of either classical (migraine with aura) or common migraine (migraine without aura) headache was assessed in a double-blind placebo-controlled crossover trial with fixed doses. The trial was carried out on 25 patients. The treatment period was set at eight weeks, with the provision of shortening or lengthening it if necessary with a maximum period of seventeen weeks. A minimum of three migraine attacks were treated during each treatment period. Patients were assessed according to: the mean duration and mean severity per treatment period of migraine attacks. The secondary efficacy assessment was made on the basis of the percentage of attacks requiring escape medication per treatment period. The study, based on the t-distribution statistical model with a confidence level of 95%, showed that propranolol had no significant effect in aborting acute attacks of migraine when compared with placebo.

scholarly journals Comparative Efficacy and Safety of Moxifloxacin and Clindamycin in the Treatment of Odontogenic Abscesses and Inflammatory Infiltrates: a Phase II, Double-Blind, Randomized Trial

2010 ◽  
Vol 55 (3) ◽  
pp. 1142-1147 ◽  
Author(s):  
Georg Cachovan ◽  
Rainer H. Böger ◽  
Ina Giersdorf ◽  
Olaf Hallier ◽  
Thomas Streichert ◽  
...  
Keyword(s):  
Comparative Efficacy ◽  
Primary Analysis ◽  
Double Blind ◽  
Once Daily ◽  
Odontogenic Infections ◽  
Perceived Pain ◽  
Clinical Responses ◽  
Efficacy Assessment ◽  
The Mean ◽  
Inflammatory Infiltrates

ABSTRACTMoxifloxacin penetrates well into oromaxillary tissue and covers the causative pathogens that show an increasing resistance to standard antibiotics. Clinical reports suggest that moxifloxacin may be effective for the treatment of odontogenic infections that can lead to serious complications. The objective of this prospective, randomized, double-blind, multicenter study was to compare the efficacies and safeties of moxifloxacin and clindamycin for the medical treatment of patients with gingival inflammatory infiltrates and as an adjuvant therapy for patients with odontogenic abscesses requiring surgical treatment. Patients received either 400 mg moxifloxacinper osonce daily or 300 mg clindamycinper osfour times daily for 5 days consecutively. The primary efficacy endpoint was the percent reduction in patients' perceived pain on a visual analogue scale at days 2 to 3 from baseline. Primary analysis included 21 moxifloxacin- and 19 clindamycin-treated patients with infiltrates and 15 moxifloxacin- and 16 clindamycin-treated patients with abscesses. The mean pain reductions were 61.0% (standard deviation [SD], 46.9%) with moxifloxacin versus 23.4% (SD, 32.1%) with clindamycin (P= 0.006) for patients with infiltrates and 55.8% (SD, 24.8%) with moxifloxacin versus 42.7% (SD, 48.5%) with clindamycin (P= 0.358) for patients with abscesses. A global efficacy assessment at days 2 to 3 and 5 to 7 showed faster clinical responses with moxifloxacin in both abscess and infiltrate patients. Rates of adverse events were lower in moxifloxacin- than in clindamycin-treated patients. In patients with inflammatory infiltrates, moxifloxacin was significantly more effective in reducing pain at days 2 to 3 of therapy than clindamycin. No significant differences between groups were found for patients with odontogenic abscesses.

Metoprolol and Pizotifen in The Prophylactic Treatment of Classical and Common Migraine. A Double-Blind Investigation

Cephalalgia ◽  
1985 ◽  
Vol 5 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Steinar Vilming ◽  
Brit Standnes ◽  
Christer Hedman
Keyword(s):  
Weight Gain ◽  
Side Effects ◽  
Prophylactic Treatment ◽  
Double Blind ◽  
Major Drawback ◽  
Serotonin Antagonist ◽  
Beta Adrenoceptor ◽  
Adrenoceptor Antagonist ◽  
Significant Difference

The prophylactic anti-migraine effect of the serotonin antagonist pizotifen and the beta1-selective beta-adrenoceptor antagonist metoprolol was compared in a double-blind cross-over study. The dosage of pizotifen was 0.5 mg t.i.d. and that of metoprolol 50 mg b.i.d. Thirty-five patients with classical or common migraine were included in the investigation. Five patients withdrew during the course of the study; four because of side effects (three on pizotifen, one on metoprolol) and one because of unassociated illness. The results show that there was no statistically significant difference in efficacy between metoprolol and pizotifen. The tolerance, especially regarding weight gain, was the major drawback with pizotifen, while metoprolol was generally well tolerated.

The Antihypertensive Effect of Verapamil in Twice and Thrice Daily Dose Regimens. A Randomized, Double-Blind, Crossover Trial

1983 ◽  
Vol 11 (3) ◽  
pp. 190-193 ◽  
Author(s):  
B Hedbäck ◽  
K Parment
Keyword(s):  
Dose Regimen ◽  
Crossover Trial ◽  
Antihypertensive Effect ◽  
Morning Dose ◽  
Double Blind ◽  
Daily Dose ◽  
The Mean ◽  
Daily Dose Regimen ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

The antihypertensive effect of verapamil 200 mg b.i.d. was compared with that of verapamil 120 mg t.i.d. in a double-blind crossover study in eight out-patients with essential hypertension. The mean supine blood pressure measured before the morning dose was 150/87 mm Hg in patients treated with verapamil 200 mg b.i.d. and 151/87 mm Hg in those treated with verapamil 120 mg t.i.d. The recently reported prolonged half-life and accumulation of verapamil during steady-state conditions explains the lasting antihypertensive effect with the twice-daily dose regimen. Such a twice daily dose regimen is presumed to be more convenient to the patients and thus improve their compliance.

scholarly journals Absorption of Different Salts of Heparin Following Subcutaneous Injection

1977 ◽  
Author(s):  
G. Cella ◽  
D.A. Lane ◽  
I. MacGregor ◽  
V.V. Kakkar
Keyword(s):  
Subcutaneous Injection ◽  
Crossover Trial ◽  
Subcutaneous Tissue ◽  
Gel Filtration ◽  
Post Injection ◽  
Double Blind ◽  
Inorganic Ion ◽  
Thrombosis Research ◽  
The Mean ◽  
Low Levels

Two recent studies (1,2) have demonstrated that the MW of heparin and nature of the inorganic ion associated with it influence the heparin level in blood following subcutaneous injection. In the present study we have studied the absorption of heparins containing different amounts of Na and Ca and yet all having similar MW’s when characterized by gel filtration upon a polyacrylamide-agarose matrix (3). Four heparins from the same source material containing approximately 11% Na, 2.5% Ca, 7%, 10.5% Ca together with two Na salts and two Ca salts that are commercially available have been studied in a double-blind crossover trial in six normal volunteers. It was found that mean heparn levels circulating 1, 3, 5 and 7 hours post injection fell as the% of Ca associated with the heparins increased. The differences between the mean levels obtained following injection of the Na salts and the 10-11% Ca salts were highly significant at 1, 3 and 5 hours, while differences between Na salt and 7.3% Ca were significant only at 1 hour post injection. In one individual with small amounts of subcutaneous tissue inconsistent results were obtained, with two Ca salts (7.3% and 11%) producing twice the levels obtained following subcutaneous injection of the Na salts and another Ca salt (10.5%) producing characteristically low levels.1. Johnson, E.A. et al. Thrombosis and Haemostasis 35: 586, 1976.2. Thomas, D.P. et al. Thrombosis Research 9: 241, 1976.3. Johnson, E.A. and Mulloy, B. Carbohydrate Research 51: 119, 1976.

Combined Low-Dose Acetylsalicylic Acid and Dihydroergotamine in Migraine Prophylaxis: A Double-Blind, Placebo-Controlled Crossover Study

Cephalalgia ◽  
1988 ◽  
Vol 8 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Marie Germaine Bousser ◽  
Jacques Chick ◽  
Eliane Fuseau ◽  
Thierry Soisson ◽  
Robert Thevenet
Keyword(s):  
Beneficial Effect ◽  
Acetylsalicylic Acid ◽  
Active Treatment ◽  
Low Dose ◽  
Crossover Trial ◽  
Migraine Prophylaxis ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Acute Medication ◽  
The Mean

The efficacy of the combination of dihydroergotamine (10 mg) with acetylsalicylic acid (80 mg) (DHE + ASA) in the prophylaxis of migraine was studied in a double-blind, placebo-controlled crossover trial (8 weeks twice). Of 45 patients who entered the study, 38 completed it. The number of attacks was significantly ( p = 0.003) reduced during active treatment (11.5 ± 6.2) compared with placebo (16.6 ± 9.9). The mean duration, the mean severity, and the mean score for symptomatic acute medication of attacks did not differ significantly. The overall assessment made by the patients themselves was in favor of DHE + ASA ( p = 0.001). These results indicate a moderately beneficial effect of the dihydroergotamine/low-dose acetylsalicylic acid combination in migraine prophylaxis.

Efficacy and safety of exogenous beta-hydroxybutyrate for preventive treatment in episodic migraine: A single-centred, randomised, placebo-controlled, double-blind crossover trial

Cephalalgia ◽  
2021 ◽  
pp. 033310242110437
Author(s):  
Niveditha Putananickal ◽  
Elena C Gross ◽  
Anna-Lena Orsini ◽  
Simone Schmidt ◽  
Patricia Hafner ◽  
...  
Keyword(s):  
Treatment Period ◽  
Ketogenic Diet ◽  
Crossover Trial ◽  
Substantial Reduction ◽  
Episodic Migraine ◽  
Prophylactic Effect ◽  
Double Blind ◽  
Migraine Frequency ◽  
Beta Hydroxybutyrate ◽  
Episodic Migraineurs

Background Several studies propose that brain energy deficit might be partially involved in the pathophysiology of migraine. Previously, studies demonstrated that ketogenic diet causes a substantial reduction in migraine frequency. Since the ketogenic diet is restricting and its adherence is difficult, we proposed to supplement ketone bodies exogenously to provide a prophylactic effect in migraineurs. Aim To evaluate the prophylactic effect of exogenous DL-beta-hydroxybutyrate supplementation in episodic migraineurs. Methods A double-blind, placebo-controlled, randomised crossover trial was conducted, involving 41 patients with episodic migraine. Patients were randomised 1:1 into placebo or beta-hydroxybutyrate group before entering the first treatment period. Each treatment period was 12 weeks long, followed by four weeks of washout phase and four weeks of run-in phase before entering into the corresponding second treatment period. The primary endpoint was the number of migraine days in the last four weeks of treatment, adjusted for baseline. Results We observed no clinically significant amelioration of migraine frequency or intensity under DL-beta-hydroxybutyrate treatment as compared to placebo regarding number of migraine days (mean difference [95% CI]: −1.1[−5.07, 2.85]), migraine intensity (0–10 VAS: 1.5[−0.8, 3.7]). Conclusion The selected dose of supplemented exogenous DL-beta-hydroxybutyrate did not demonstrate efficacy in episodic migraineurs. ClinicalTrials.gov Identifier: NCT03132233

scholarly journals Low-Dose Naltrexone/Acetaminophen Combination in the Preventive Treatment of Migraine: Findings of a Small, Randomized, Double-Blind, and Placebo-Controlled Clinical Trial with an Open-Label Extension for None-Responders

2021 ◽  
Author(s):  
Annette Channa Toledano
Keyword(s):  
Treatment Period ◽  
Low Dose ◽  
Preventive Treatment ◽  
Episodic Migraine ◽  
Controlled Clinical Trial ◽  
Migraine Prevention ◽  
Open Label ◽  
Double Blind ◽  
The Mean ◽  
Low Dose Naltrexone

We tested low-dose naltrexone/acetaminophen combination for episodic migraine prevention. We randomly assigned patients to naltrexone/acetaminophen (n=6) or placebo (n=6) for a 12-week double-blind treatment. Non-responders continued into open-label treatment with naltrexone/acetaminophen (n=5) for additional 12 weeks. Patients were adults who experienced 5 to 17 (average 9.7) migraine days at baseline. The primary endpoint was the mean change in the monthly migraine days during the last 4 weeks of the double-blind treatment period. The key secondary endpoint was the mean change in the monthly migraine days from the 4–week double–blind follow–up (2nd baseline) to the last 4 weeks of the open–label treatment period. The magnitude of the treatment effect for naltrexone/acetaminophen observed in the double–blind period was 2.2 fewer monthly migraine days than placebo (p=0.43). Four out of 6 (66.7%) naltrexone/acetaminophen-treated patients experienced 75% reduction in migraine days compared to 1 out of 6 (16.7%) placebo-treated patients (p=0.09). In the open-label phase, treatment with naltrexone/acetaminophen (n=5) led to 8.2 fewer mean monthly migraine days (from 11.8 to 3.6), representing 69.5% improvement (p=0.03), and 100% of the patients experienced a 50% reduction in monthly migraine days. Adverse events were mild/moderate and transient, included dry mouth, fatigue, sedation, nausea, and feeling jittery. We postulate that naltrexone′s toll-like receptor (TLR4) antagonism properties prevent pro-inflammatory cytokines′ production in the trigeminal ganglion averting ″overactive nerves″ and migraine. Although this trial used low-dose naltrexone (defined as 1 – 5 mg/day), we postulate mid-dose naltrexone (MDN) (defined as 6 – 10 mg/day) may offer a greater migraine prevention control.

scholarly journals Dietary fructo-oligosaccharides in healthy adults do not negatively affect faecal cytotoxicity: a randomised, double-blind, placebo-controlled crossover trial

2006 ◽  
Vol 95 (6) ◽  
pp. 1143-1149 ◽  
Author(s):  
Petra A. M. J. Scholtens ◽  
Martine S. Alles ◽  
Linette E. M. Willemsen ◽  
Claudia van den Braak ◽  
Jacques G. Bindels ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Random Order ◽  
Healthy Adults ◽  
Negative Effects ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Bacterial Fermentation ◽  
Regular Diet ◽  
Human Adults ◽  
The Mean

Fructo-oligosaccharides (FOS) are widely used in commercial food products. Most studies on FOS concern the health benefits, but some negative effects were recently reported concerning thefaecal cytotoxicity and excretion of mucin-type oligosaccharides in combination with a Ca-restricted diet. The present study was performed to investigate whether these effects of FOS are observed in adults consuming a regular diet unrestricted in Ca. The study was a randomised, double-blind, placebo-controlled crossover trial, involving eleven healthy adults, who consumed 25–30g FOS or maltodextrin (control) in a random order for 2 weeks in addition to their regular diet. Stools were collected for analysis of pH and SCFA (as markers of fermentation), for the assessment of faecal water cytotoxicity, and for the analysis of alkaline phosphataseactivity (as a marker of epithelial cell turnover) andO-linked oligosaccharides (to estimate the excretion of mucin-type oligosaccharides). FOS consumption significantly altered bacterial fermentation (increased percentage of acetate, decreased percentage of butyrate) and tended to decrease stool pH. Furthermore, FOS consumption resulted in a significantly higher stool frequency and in significantly more complaints of flatulence. No significant differences between the control and FOS period were observed in the mean cytotoxicity of faecal water (37·5 (sem 6·9) % v. 18·5 (sem 6·9) % P=0·084), in mean alkaline phosphatase activity (27·7 (sem 2·9) v. 24·6 (sem 3·2) U/g dry faeces; P=0·496) or in the mean excretion of mucin-type oligosaccharides (49·9 (sem 4·0)v. 53·5 (sem 4·3) mg/g dry faeces; P=0·553). We conclude that dietary FOS in a dose up to 25–30g/d altered the bacterial fermentation pattern but did not affect faecal cytotoxicity or the faecal concentration of mucin-type oligosaccharides in human adults consuming a regular diet.

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