scholarly journals What Is the Evidence that Riboflavin Can Be Used for Migraine Prophylaxis?

2016 ◽  
Vol 27 (1) ◽  
pp. 7 ◽  
Author(s):  
Tracey N. Liebman ◽  
Sara C. Crystal
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Mitochondrial Dysfunction ◽  
Symptomatic Treatment ◽  
Oxygen Metabolism ◽  
Migraine Prophylaxis ◽  
Vitamin B2 ◽  
Double Blind ◽  
Prophylactic Agent

Individuals with migraine often have recurrent, painful symptoms, and symptomatic treatments have detrimentalside effects and do not prevent further attacks. Studies indicate that riboflavin can be used to decrease headachefrequency and lessen the need for symptomatic treatment. Mitochondrial dysfunction may play a role in migrainepathogenesis by interfering with oxygen metabolism. Daily doses of riboflavin, vitamin B2, may improve mitochondrialfunction by increasing the reserve of brain mitochondrial energy, and there are minimal side effects with dailytreatment. However, there is a need for further randomized, double-blind controlled studies to determine the effectivedose. Although riboflavin may not fully eliminate migraine nor take effect for several months, riboflavin is apromising prophylactic agent with minimal adverse effects that may significantly reduce the frequency of migraine.

Cinnarizine and sodium valproate as the preventive agents of pediatric migraine: A randomized double-blind placebo-controlled trial

Cephalalgia ◽  
2019 ◽  
Vol 40 (7) ◽  
pp. 665-674
Author(s):  
Man Amanat ◽  
Mansoureh Togha ◽  
Elmira Agah ◽  
Mahtab Ramezani ◽  
Ali Reza Tavasoli ◽  
...  
Keyword(s):  
Placebo Group ◽  
Adverse Effects ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Sodium Valproate ◽  
Medical Center ◽  
Controlled Trial ◽  
Migraine Prophylaxis ◽  
Double Blind ◽  
Double Blind Placebo

Background Few migraine preventive agents have been assessed in a pediatric population. We evaluated the safety and efficacy of cinnarizine and sodium valproate for migraine prophylaxis in children and adolescents. Methods We carried out a randomized double-blind placebo-controlled trial in the Children’s Medical Center and Sina hospital, Tehran, Iran. Eligible participants were randomly assigned in 1:1:1 ratio via interactive web response system to receive either cinnarizine, sodium valproate, or placebo. The primary endpoints were the mean change in frequency and intensity of migraine attacks from baseline to the last 4 weeks of trial. The secondary endpoint was the efficacy of each drug in the prevention of migraine. The drug was considered effective if it decreased migraine frequency by more than 50% in the double-blind phase compared with the baseline. Safety endpoint was adverse effects that were reported by children or their parents. Results A total of 158 children participated. The frequency of migraine attacks significantly reduced compared to baseline in cinnarizine (difference: −8.0; 95% confidence interval (CI): −9.3 to −6.6), sodium valproate (difference: −8.3; 95% confidence interval: −9.3 to −7.2), and placebo (difference: −4.4; 95% confidence interval: −5.4 to −3.4) arms. The decrease was statistically greater in cinnarizine (difference: −3.6; 95% confidence interval: −5.5 to −1.6) and sodium valproate (difference: −3.9; 95% confidence interval: −5.8 to −1.9) arms, compared to placebo group. Children in all groups had significant reduction in intensity of episodes compared to baseline (cinnarizine: −4.6; 95% confidence interval: −5.2 to −4.0; sodium valproate: −4.0; 95% confidence interval: −4.8 to −3.3; placebo: −2.6; 95% confidence interval: −3.4 to −1.8). The decrease was statistically greater in cinnarizine (difference: −2.0; 95% confidence interval: −3.2 to −0.8) and sodium valproate (difference: −1.5; 95% confidence interval: −2.7 to −0.3) arms, compared to the placebo group. Seventy-one percent of individuals in the cinnarizine group, 66% of cases in the sodium valproate group, and 42% of people in the placebo arm reported more than 50% reduction in episodes at the end of the trial. The odds ratio for >50% responder rate was 3.5 (98.3% confidence interval: 1.3 to 9.3) for cinnarizine versus placebo and 2.7 (98.3% confidence interval: 1.0 to 6.9) for sodium valproate versus placebo. Nine individuals reported adverse effects (three in cinnarizine, five in sodium valproate, and one in the placebo group) and one case in the sodium valproate group discontinued the therapy due to severe sedation. Conclusion Cinnarizine and sodium valproate could be useful in migraine prophylaxis in children and adolescents. Trial registration: IRCT201206306907N4.

scholarly journals Self-perception of side effects by adolescents in a chlorhexidine-fluoride-based preventive oral health program

2006 ◽  
Vol 14 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Ana Rita Duarte Guimaraes ◽  
Marco Aurélio Peres ◽  
Ricardo de Sousa Vieira ◽  
Rodrigo Melin Ferreira ◽  
Maria Letícia Ramos-Jorge ◽  
...  
Keyword(s):  
Oral Health ◽  
Side Effects ◽  
Adverse Effects ◽  
Health Program ◽  
Double Blind Study ◽  
Chi Square ◽  
Double Blind ◽  
Chi Square Test ◽  
Plaque Control ◽  
Descriptive Scale

OBJECTIVE: The objective of this study was to evaluate the incidence of adverse effects reported by adolescents following 14 days of use of a mouthrinse containing 0.05% NaF+0.12% chlorhexidine. METHODS: This double-blind study was developed as part of a randomized clinical trial. The adolescents enrolled to the study were randomly divided into two groups to use either: 0.05% NaF+0.12% chlorhexidine (G1, n=85) or 0.05% NaF (G2, n=85). Both groups used a 10mL solution of the mouthwash during 1 minute daily for 2 weeks under supervision. After that period, the subject's acceptance of taste was measured using a verbal descriptive scale (Labeled Magnitude Scale - LMS)11. Participants were also interviewed regarding the occurrence of possible adverse effects during treatment (temporary palate disorders, tooth staining or unpleasant taste). The proportional differences between the groups were tested using the chi-square test. RESULTS: Palate changes were reported by 26% of participants of each group; 17.7% of G1 and 32% of G2 reported an unpleasant taste (p = 0.062), while staining was reported by 55% of G1 and 68.9% of G2 (p = 0.117). Absenteeism rates were similar in both groups (G1= 2.58 ± 2.69; G2=2.81 ± 2.39), p=0.362. CONCLUSION: adherence was high in both groups and side effects reported by subjects were not perceived by them as being important. Since subjects' acceptance and compliance is fundamental to the success of an oral health program, chlorhexidine-fluoride could be a useful resource in a program of plaque control.

Iohexol and Meglumine Iothalamate in Shoulder Arthrography

1985 ◽  
Vol 26 (6) ◽  
pp. 757-760
Author(s):  
K. Tallroth ◽  
E. Vankka
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Contrast Medium ◽  
Consecutive Series ◽  
Contrast Injection ◽  
Double Blind ◽  
Shoulder Arthrography ◽  
Meglumine Iothalamate ◽  
Blind Comparison ◽  
Conventional Medium

The first clinical experience with the new contrast medium, iohexol, in shoulder arthrography is reported. A double-blind comparison of iohexol and meglumine iothalamate, a conventional medium in standard use for arthrography, was carried out in a consecutive series of 60 adult patients forming two groups of 30 subjects each. No difference in the radiographic quality was seen immediately after contrast injection but in exposures at 20 min iohexol gave a significantly better arthrographic quality. Practically no adverse effects occurred during the examinations. Although minor side effects were numerous in both groups during the two days following arthrography, they were somewhat more frequent in patients given iothalamate

scholarly journals Is Oral Omega-3 Effective in Reducing Mucocutaneous Side Effects of Isotretinoin in Patients with Acne Vulgaris?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mina Mirnezami ◽  
Hoda Rahimi
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Acne Vulgaris ◽  
Control Group ◽  
Case Group ◽  
Omega 3 ◽  
Double Blind ◽  
Severe Acne ◽  
Double Blind Clinical Trial ◽  
And Control

Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with  IRCT201306238241N2.

Effect of Combining Naloxone and Morphine for Intravenous Patient-controlled Analgesia

2003 ◽  
Vol 99 (1) ◽  
pp. 148-151 ◽  
Author(s):  
James B. Sartain ◽  
John J. Barry ◽  
Christopher A. Richardson ◽  
Helen C. Branagan
Keyword(s):  
Side Effects ◽  
Controlled Trial ◽  
Symptomatic Treatment ◽  
General Anesthetic ◽  
Patient Controlled Analgesia ◽  
Double Blind ◽  
Pain Scores ◽  
Patient Recall ◽  
Background Infusion ◽  
Pain At Rest

Background An early study showed that a naloxone infusion decreased the incidence of morphine-related side effects from intravenous patient-controlled analgesia. The authors tested the hypothesis that a more convenient combination of morphine and naloxone via patient-controlled analgesia would decrease the incidence of side effects compared to morphine alone. Methods Patients scheduled for hysterectomy under general anaesthesia were enrolled in a double-blind, randomized, placebo-controlled trial. Patients received a standardized general anesthetic and postoperative patient-controlled analgesia. They were randomized to receive 60 mg patient-controlled analgesia morphine in 30 ml saline or 60 mg morphine in 30 ml saline with naloxone 0.8 mg. Parameters for patient-controlled analgesia were a 1-mg bolus of morphine with a 5-min lockout and no background infusion. Patient recall of nausea, vomiting, itching, and pain (at rest and with movement) were assessed at 6 and 24 h postoperatively by verbal rating score. Pain was also assessed by a 0- to 100-mm visual analog score, and sedation was assessed by an observer. The amount of morphine used and the requirements for symptomatic treatment were also recorded. Results Ninety-two patients completed the study, with no significant differences in outcomes between groups. At 24 h, the incidence of nausea was 84.8% in each group; the incidence of pruritus was 56.5% in the naloxone group and 58.7% in the placebo group. There were also no differences in symptomatic treatment requirements, pain scores, morphine use, or sedation between groups. The median dose of naloxone received equated to 0.38 microg x kg-1 x h-1 over 24 h. Conclusions There was no benefit from administering naloxone combined with morphine via patient-controlled analgesia.

Comparison of Propranolol LA 80 mg and Propranolol LA 160 mg in Migraine Prophylaxis: A Placebo Controlled Study

Cephalalgia ◽  
1993 ◽  
Vol 13 (2) ◽  
pp. 128-131 ◽  
Author(s):  
Hisham K Al-Qassab ◽  
Leslie J Findley
Keyword(s):  
Side Effects ◽  
Migraine Prophylaxis ◽  
Controlled Study ◽  
Headache Frequency ◽  
Double Blind ◽  
Once Daily ◽  
Double Blind Placebo ◽  
Headache Severity ◽  
Negative Effect ◽  
Long Acting

Thirty patients with severe classical and common migraine participated in a double-blind placebo-con-trolled cross-over study of migraine prophylaxis with propranolol LA (long-acting) 80 mg once daily, or propranolol LA 160 mg once daily or placebo. Each treatment was given for two months. There were no significant differences between the three treatment periods in headache frequency, headache severity, nausea frequency or severity. There was a non-significant trend for reduced duration of headache with the two doses of propranolol. The possible reasons for this negative effect are discussed. The safety of propranolol and its lack of serious side effects were demonstrated.

Flunarizine-Pizotifen Single-Dose Double-Blind Cross-Over Trial in Migraine Prophylaxis

Cephalalgia ◽  
1986 ◽  
Vol 6 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Rosanna Cerbo ◽  
Massimo Casacchia ◽  
Rita Formisano ◽  
Massimo Feliciani ◽  
Giuliana Cusimano ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Single Dose ◽  
Weight Gain ◽  
Side Effects ◽  
Migraine Prophylaxis ◽  
Calcium Entry Blocker ◽  
Prophylactic Effect ◽  
Double Blind ◽  
Dose Administration ◽  
Definite Difference

The results of a double-blind cross-over clinical trial involving 27 patients with classical or common migraine are described to compare the prophylactic effect of the calcium entry-blocker flunarizine with that of pizotifen. Duration of the treatment was two months, with an evening single-dose administration of both drugs. For most parameters, there was no definite difference between flunarizine and pizotifen in migraine prophylaxis. It has been demonstrated previously that pizotifen is an effective drug in migraine prophylaxis, and these results suggest that flunarizine is effective, too. Weight gain as a side effect was less frequent and less severe with flunarizine than with pizotifen; other side effects showed the same incidence with both drugs.

A Double-Blind Comparison of Terfenadine and Mequitazine in the Symptomatic Treatment of Acute Pollinosis

1986 ◽  
Vol 14 (3) ◽  
pp. 124-130 ◽  
Author(s):  
L Hugonot ◽  
R Hugonot ◽  
D Beaumont ◽  
Cahen ◽  
Colomby ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Symptomatic Treatment ◽  
Geographic Area ◽  
Diary Card ◽  
Onset Of Action ◽  
Blurred Vision ◽  
Double Blind ◽  
Significant Difference ◽  
The Difference

This study was a double-blind, parallel group comparison of terfenadine (TRF) 60 mg b.i.d. and mequitazine (MQZ) 5 mg b.i.d. for 7 days in the symptomatic treatment of acute pollinosis. The trial took place in the same geographic area and during the same pollen season (May-July 85), to ensure homogeneity of the study population. The fourteen investigators participating in this multicentre trial recruited 141 patients (69 TRF; 72 MQZ) suffering from well-documented pollinosis, mainly hay fever and sometimes allergy to tree pollens. Symptoms (nasal itching, sneezing, rhinorrhoea, obstruction, conjunctivitis) and possible somnolence were rated daily using a 4-point rating-scale of 0 to 3 by the patient on a diary card. Assessment of over-all efficacy and tolerability – focusing on atropinic side-effects – was made at the end of the seven-days treatment period by the physician, after reviewing the diary card and questioning the patient. The means score profile of each symptom for the study period was similar with the two treatments. Both had a fast onset of action with the regression of the total symptoms' score being already significant at day 1. Over-all assessment of efficacy at day 7 showed no significant difference between the two treatments. The daily somnolence scores however showed a clear and significant difference between the two drugs: the frequency of moderate to marked somnolence from day 2 to 7 was around 15% with MQZ and around 5% on days 2 to 5 and 0% on days 6 and 7 with TRF, the difference being significant on days 2, 5, 6 and 7. The incidence of blurred vision was 7% with MQZ requiring cessation of therapy in one patient, compared with 0% with TRF (p < 0-06). Side-effects other than somnolence and atropinic effects were reported in two TRF and six MQZ patients. In conclusion terfenadine and mequitazine displayed the same efficacy for symptoms of pollinosis, but terfenadinie was better tolerated.

scholarly journals Spectrum of Adverse Effects and it’s Associations in Patient Medicated with Anti-Tubercular Drugs

2021 ◽  
Author(s):  
Priyatam Khadka ◽  
Bhagwati Rai ◽  
Prem Khadga
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Drug Effects ◽  
Control Program ◽  
Treatment Phase ◽  
Symptomatic Treatment ◽  
Fixed Dose ◽  
Logistic Analysis ◽  
Multivariate Logistic Analysis

Abstract BackgroundEvidence suggests that adverse drug effects (ADRs) from long-term therapeutic intervention in tuberculosis are obvious; however, were taken insouciantly due to the only therapeutic alternative. Hence, this study was undertaken to characterize the adverse effects and its association among patients medicated with anti-tubercular drugs.MethodsA longitudinal prospective study was conducted among the patient medicated with anti-tubercular drugs. As per the guideline of Nepal’s National tuberculosis control program (NTP);the treatment category was selected, fixed-dose-regimen was calculated, and the treatment outcome was affirmed. Patients’ demographics and other clinical details were extracted from the repository files and via a pre-tested questionnaire. Upon a consecutive follow-up, observed adverse effects were noted and multivariate logistic analysis against independent factors was done for elucidating any association.ResultsOf 177 cases enrolled, 138(77.9%) reported at least two adverse effects. In our multivariate logistic analysis: female, abnormal body mass index (BMI) i.e. underweight and overweight cases, patients’ behaviors i.e. smoking/drinking or both, clinically diagnosed cases, and intensive treatment phase were independently associated with adverse side effects. Loss of appetite (85.4%) was the commonest while dermatologic manifestations (1.2%) and severe weight-loss (1.2%) were the least observed side-effects among the patient medicated with anti-tubercular drugs.ConclusionsAdverse effects of anti-tubercular therapy are associated with patients’ demographics variables, study settings, treatment phase, and treatment categories. For the clinical management, the symptomatic treatment, regular follow-up after implicated therapy, and temporary therapeutic-discontinuation may be required.

Supplementation with Riboflavin (Vitamin B2) for Migraine Prophylaxis in Adults and Children: A Review

2015 ◽  
Vol 85 (1-2) ◽  
pp. 79-87 ◽  
Author(s):  
Nazli Namazi ◽  
Javad Heshmati ◽  
Ali Tarighat-Esfanjani
Keyword(s):  
Side Effects ◽  
Key Words ◽  
English Language ◽  
Migraine Prophylaxis ◽  
Vitamin B ◽  
Vitamin B2 ◽  
Insufficient Evidence ◽  
Positive Role ◽  
Migraine Pathogenesis ◽  
Adults And Children

Abstract. Background and Aim: Migraine is a unilateral and pulsating headache associated with nausea, photophobia, vomiting, and sensitivity to light. Low vitamin B2 can lead to mitochondrial dysfunction and may have an effect on migraine pathogenesis. The aim of the present study was to carry out a review of existing evidence regarding the effects of riboflavin (vitamin B2) supplementation on migraine prophylaxis in adults and children. Material and Methods: We searched the databases of PubMed, Science Direct, Google Scholar, and Springer between 1990 and December 2013. Key words included vitamin B2, riboflavin, migraine, vomiting headache, and prevention. We limited our search to human studies in the English language. Review articles and abstracts from symposiums and conferences were excluded. Results: Finally, eleven eligible articles were found: seven involved studies with adults and four involved studies with children. The results indicated that supplementation with vitamin B2 in adults can play a positive role in reducing the frequency and duration of migraine attacks with no serious side effects. Conclusions: It seems that riboflavin is a safe and well-tolerated option for preventing migraine symptoms in adults, however, there is insufficient evidence to make recommendations regarding vitamin B2 as an adjunct therapy in adults and children with migraine.

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