lisinopril and Migraine-Disorders

Topics: Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Biphenyl Compounds; Humans; Lisinopril; Migraine Disorders; Tetrazoles

The treatment of migraine depends on the frequency, severity and concomitant diseases. There are several specific drugs developed for migraine prevention in addition to the additive antimigraine effects of some other non-specific drugs. The aim of this literature-based review is to summarize the possible antimigraine properties of different antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, etc.) focusing on the possible side effects (avoidance of beta blockers in the absence of heart disease, possible antiparkinson effect of calcium channel blockers, additive effect of drugs modifying the renin-angiotensin system activity, etc.). Current evidence supports the use of angiotensin converting enzyme inhibitors (mainly lisinopril) and angiotensin receptor blockers (mainly candesartan) for long-term migraine prevention and blood pressure control. Long-term beta-blocker treatment should be avoided in the absence of ischemic heart disease due to possible unfavourable cardiovascular effects.. A migrén kezelési stratégiája a fejfájás gyakoriságától és súlyosságától, továbbá az egyidejűleg fennálló egyéb betegségektől függ. Számos gyógyszert hoztak forgalomba kimondottan a migrén kezelésére, azonban primeren más betegség kezelésére alkalmas szer is hasznos lehet. A szerzők irodalmi kutatáson alapuló munkájának célja a vérnyomáscsökkentő szerek (béta-blokkoló, kalciumcsatorna-blokkoló, angiotenzinkonvertálóenzim-gátló, angiotenzinreceptor-blokkoló és egyéb szerek) migrénprofilaxisban való szerepének és a kedvező hatást alátámasztó bizonyítékok áttekintése. Vizsgálták továbbá e szerek egyéb hatásait (cardiovascularis hatás, béta-blokkolók szívbetegség hiányában való adásának potenciálisan hátrányos hatásai, esetleges extrapyramidalis mellékhatások kalciumcsatorna-blokkolók alkalmazásakor, angiotenzinkonvertálóenzim-gátló és angiotenzinreceptor-blokkoló szerek egyéb additív hatásai). A rendelkezésre álló bizonyítékok alapján strukturális szívbetegség hiányában migrén és hypertonia együttes fennállása esetén angiotenzinkonvertálóenzim-gátló (elsősorban lisinopril) vagy angiotenzinreceptor-blokkoló (elsősorban candesartan) kezelés ajánlott, szívbetegség esetén javasolt csak béta-blokkoló hosszú távú adása. Orv. Hetil., 2015, 156(5), 179–185.

Topics: Adrenergic beta-Antagonists; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Benzimidazoles; Biphenyl Compounds; Calcium Channel Blockers; Contraindications; Humans; Lisinopril; Migraine Disorders; Renin-Angiotensin System; Tetrazoles; Tryptamines

To evaluate the literature examining the efficacy of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) for migraine prophylaxis.. MEDLINE (1966-October 2009) and International Pharmaceutical Abstracts were searched using the terms migraine, headache, renin-angiotensin system, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, aldosterone antagonist, and the individual agents in these classes.. English-language human clinical trials, case reports, and systematic reviews were evaluated for efficacy and safety data. The references of reviewed articles were examined to identify additional sources.. Preventative trials evaluating ACE inhibitors consist of a case series, 2 open-label trials, and a placebo-controlled trial. Lisinopril reduced headache hours 20%, headache days 17%, and migraine days 21% versus placebo in the controlled trial (p < 0.05). Clinically significant (>50%) reductions in migraine measures were more common (52-66%) in open-label ACE inhibitor trials than in the controlled (32-36%) trial. Preventive trials evaluating ARBs consist of a meta-analysis, an open-label trial, and 2 placebo-controlled trials. Candesartan reduced headache hours 31%, headache days 26%, and migraine days 28% versus placebo in the first controlled trial (p < or = 0.001). Telmisartan did not reduce any prespecified primary or secondary outcome measures in the second controlled trial. Clinically significant reductions (>50%) in migraine measures were more common (54-88%) in open-label ARB trials than in the controlled (26-38%) trials. A prescription database review found that ACE inhibitor or ARB therapy halved the use of abortive migraine agents compared to diuretic therapy.. ACE inhibitors and ARBs have migraine prophylaxis activity similar to that of some currently utilized agents. Low-dose lisinopril or candesartan may be reasonable second- or third-line agents, particularly in patients with other indications for ACE inhibitor or ARB therapy. Further controlled clinical trials are needed to delineate the role of these agents in migraine prevention.

Topics: Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Biphenyl Compounds; Clinical Trials as Topic; Humans; Lisinopril; Migraine Disorders; Renin-Angiotensin System; Tetrazoles; Treatment Outcome

In this paper we review new treatment options for migraine prevention. We start with an overview about migraine and then briefly discuss current indications for migraine prevention and new and emerging preventive medications.

Topics: Adrenergic alpha-Agonists; Adrenergic beta-Antagonists; Anticonvulsants; Antidepressive Agents; Antihypertensive Agents; Calcium Channel Blockers; Coenzymes; Drug Therapy; Humans; Levetiracetam; Lisinopril; Migraine Disorders; Petasites; Piperazines; Piracetam; Preventive Medicine; Triazoles; Ubiquinone

In this paper we review new treatment options for migraine prevention. Because we focus on new drugs, some of the data we present herein were acquired in well design double blind, controlled studies, while the efficacy of other medication is supported only by open, uncontrolled trials (noted in the text wherever appropriate).

Topics: Analgesics; Angiotensin-Converting Enzyme Inhibitors; Antidepressive Agents, Second-Generation; Antioxidants; Benzimidazoles; Biphenyl Compounds; Botulinum Toxins; Clonidine; Coenzymes; Fructose; Humans; Lisinopril; Migraine Disorders; Neuroprotective Agents; Petasites; Phytotherapy; Piperazines; Tetrazoles; Topiramate; Triazoles; Ubiquinone

Topics: Acetaminophen; Adolescent; Adult; Aged; Analgesics; Analgesics, Non-Narcotic; Angiotensin-Converting Enzyme Inhibitors; Antidepressive Agents; Antidepressive Agents, Tricyclic; Chronic Disease; Controlled Clinical Trials as Topic; Double-Blind Method; Female; Headache; Humans; Lisinopril; Male; Meta-Analysis as Topic; Middle Aged; Migraine Disorders; Placebos; Serotonin Receptor Agonists; Sumatriptan; Tension-Type Headache; Time Factors

The ACE-inhibitor lisinopril has previously been shown to be effective in migraine prophylaxis at a daily dose of 20 mg. To test the effect of a low dose of lisinopril (5 mg daily) in migraine prevention, we performed an open label study in 21 migraineurs. The primary outcome measure was frequency of migraine attacks. Secondary efficacy measures were migraine hours, intake of acute migraine drugs, pain intensity and responder rate. Compared with baseline conditions, the attack frequency of migraine attacks was significantly reduced (P < 0.0005). The number of acute migraine drugs dropped significantly (P = 0.002). Three patients dropped out because of intolerable cough. Our study suggests that even low doses of lisinopril may be effective in migraine treatment. However, its use may be limited by intolerable side-effects.

Topics: Adult; Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Hypertension; Lisinopril; Male; Migraine Disorders; Time Factors; Treatment Outcome

To determine the efficacy of an angiotensin converting enzyme inhibitor in the prophylaxis of migraine.. Double blind, placebo controlled, crossover study.. Neurological outpatient clinic.. Sixty patients aged 19-59 years with migraine with two to six episodes a month.. Treatment period of 12 weeks with one 10 mg lisinopril tablet once daily for one week then two 10 mg lisinopril tablets once daily for 11 weeks, followed by a two week wash out period. Second treatment period of one placebo tablet once daily for one week and then two placebo tablets for 11 weeks. Thirty participants followed this schedule, and 30 received placebo followed by lisinopril.. Primary end points: number of hours with headache, number of days with headache, number of days with migraine. Secondary end points: headache severity index, use of drugs for symptomatic relief, quality of life and number of days taken as sick leave, acceptability of treatment.. In the 47 participants with complete data, hours with headache, days with headache, days with migraine, and headache severity index were significantly reduced by 20% (95% confidence interval 5% to 36%), 17% (5% to 30%), 21% (9% to 34%), and 20% (3% to 37%), respectively, with lisinopril compared with placebo. Days with migraine were reduced by at least 50% in 14 participants for active treatment versus placebo and 17 patients for active treatment versus run-in period. Days with migraine were fewer by at least 50% in 14 participants for active treatment versus placebo. Intention to treat analysis of data from 55 patients supported the differences in favour of lisinopril for the primary end points.. The angiotensin converting enzyme inhibitor, lisinopril, has a clinically important prophylactic effect in migraine.

Topics: Adult; Angiotensin-Converting Enzyme Inhibitors; Blood Pressure; Cross-Over Studies; Double-Blind Method; Female; Heart Rate; Humans; Lisinopril; Male; Middle Aged; Migraine Disorders; Statistics, Nonparametric

The main objective of this study was to investigate the angiotensin converting enzyme (ACE) genotype as a possible risk factor for migraine (both with and without aura) compared to controls. We also wanted to examine whether a clinical response to an ACE inhibitor, lisinopril, or an angiotensin II receptor blocker, candesartan, in migraine prophylaxis was related to ACE genotype.. 347 migraine patients aged 18-68 (155 migraine without aura (MoA), 187 migraine with aura (MwA) and 5 missing aura subgroup data) and 403 healthy non-migrainous controls > 40 years of age were included in the study. A polymerase chain reaction (PCR) was performed on the genomic DNA samples to obtain the ACE insertion (I)/deletion(D) polymorphisms.. No significant differences between migraine patients and controls were found with regard to ACE genotype and allele distributions. Furthermore, there was no significant difference between the controls and the MwA or MoA subgroups.. In our sample there is no association between ACE genotype or allele frequency and migraine. In addition, ACE genotype in our experience did not predict the clinical response to lisinopril or candesartan used as migraine prophylactics.

Topics: Adolescent; Adult; Aged; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Biphenyl Compounds; DNA Mutational Analysis; Drug Resistance; Female; Gene Deletion; Gene Frequency; Genetic Markers; Genetic Predisposition to Disease; Genetic Testing; Genotype; Humans; Lisinopril; Male; Middle Aged; Migraine Disorders; Mutagenesis, Insertional; Norway; Peptidyl-Dipeptidase A; Polymorphism, Genetic; Risk Factors; Tetrazoles

Topics: Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Benzimidazoles; Biphenyl Compounds; Clinical Trials as Topic; Humans; Lisinopril; Migraine Disorders; Renin-Angiotensin System; Tetrazoles

Topics: Adult; Angiotensin-Converting Enzyme Inhibitors; Female; Humans; Lisinopril; Male; Migraine Disorders; Randomized Controlled Trials as Topic

Seventeen patients with migraine headaches, occurring at least twice a month, were successfully treated with an ACE inhibitor for prophylaxis. Most were given enalapril, some used lisinopril. Duration of treatment ranged from 3 months to 3 years. Side effects were generally not noted. Cough occurred in four patients. The mechanism of action is unknown. The lack of side effects and the presence of clearly sustained benefit in this small group of migraineurs should prompt further study and use of this class of drugs for prophylaxis.

Topics: Adolescent; Adult; Angiotensin-Converting Enzyme Inhibitors; Enalapril; Female; Humans; Lisinopril; Middle Aged; Migraine Disorders