acenocoumarol and Migraine-Disorders

To investigate the effect of low-intensity acenocoumarol treatment (target INR 1.5 to 2.0) on the frequency and severity of migraine attacks.. The positive effect of anticoagulation on migraine has been described in case reports and observational studies.. We conducted a randomized, open, crossover study in migraine patients. After a run-in period of 8 weeks, all patients received acenocoumarol or propranolol during a period of 12 weeks and, after a washout period of 2 weeks, propranolol or acenocoumarol during a second period of 12 weeks.. Nineteen patients fulfilling the criteria were included. In 12 patients with complete data collection, only one good responder could be noted. In the other patients, treatment with low-intensity acenocoumarol did not show improvement of migraine symptoms compared with the run-in period. Treatment with propranolol showed a trend towards improvement compared with the run-in period. No serious adverse events were observed.. Overall, low-intensity acenocoumarol treatment has no prophylactic effect in migraine patients.

Topics: Acenocoumarol; Adult; Anticoagulants; Cross-Over Studies; Double-Blind Method; Female; Humans; Migraine Disorders; Propranolol; Treatment Outcome

To investigate the presence of thromboembolic risk factors and the effect of low-dose acenocoumarol therapy on migraine in patients who spontaneously reported a reduction of their migraine attacks during previous therapeutic use of anticoagulants.. The positive effect of anticoagulants on migraine has been described in case reports and observational studies. It remains unclear whether this concerns only a select group of migraineurs with certain common characteristics.. In 4 migraineurs with a self-reported reduction of attack frequency during previous use of anticoagulants (international normalization ratio [INR], 2.5:4.0), the presence of thromboembolic risk factors and the effect of low-dose acenocoumarol therapy (INR, 1.5:2.0) on migraine attacks were prospectively investigated in an open study.. All patients had one or more thromboembolic risk factors. Two patients, both with factor V Leiden heterozygosity, experienced a clear improvement of migraine during low-dose acenocoumarol therapy.. Our findings support the hypothesis that migraine, as a phenotype, has different underlying mechanisms, amongst which a thromboembolic tendency. In this group of patients, oral anticoagulants may be a suitable form of migraine prophylaxis, but this needs further clinical investigation.

Topics: Acenocoumarol; Adult; Anticoagulants; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Migraine Disorders; Prospective Studies; Risk Factors; Thrombosis; Treatment Outcome

The aim of our study was to investigate the possible effect of acenocoumarol, which is indicated for nonneurological disease, on headache.. It has been suggested that anticoagulation can have beneficial effects in the control of migraine attacks.. Four hundred randomized patients on oral anticoagulant therapy were asked to complete a questionnaire regarding their headaches.. Headache was present before or during oral anticoagulation in 166 (66 migraineurs and 100 nonmigraineurs) of 326 respondents. The major finding was that oral anticoagulation produced improvement in 63% of patients with migraine versus 38% of patients with nonmigranous headache. Improvement was related to the severity of migraine but not to age.. Oral anticoagulant therapy can improve migraine. The way in which anticoagulant therapy acts on migraine is unknown, but potential mechanisms include its effect on platelet aggregability and pharmacological effects such as suppression of enhanced nitric oxide.

Topics: Acenocoumarol; Adult; Aged; Aged, 80 and over; Anticoagulants; Female; Headache; Humans; Male; Middle Aged; Migraine Disorders; Random Allocation; Retrospective Studies; Surveys and Questionnaires

Disappearance of migraine during the use of warfarin and of phenprocoumon has been described in sporadic case reports. Treatment with heparin has also been associated with a reduction of migranous headaches. Recently, the Netherlands Pharmacovigilance Foundation LAREB received a case report concerning the diminution of migrainous headaches associated with the use of the vitamin K antagonist, acenocoumarol.

Topics: Acenocoumarol; Aged; Anticoagulants; Female; Humans; Migraine Disorders; Thrombosis