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Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review.

Abstract
Hemicrania continua (HC) is a daily continuous unilateral headache of moderate intensity with super imposed exacerbations of more severe pain accompanied by migrainous and cranial autonomic features. Response to indomethacin is an essential feature in the IHS diagnostic criteria. However, indomethacin is associated with a number of side effects. HC is a life long condition, and skipping of a single dose of indomethacin usually leads to reappearance of headache. Various drugs have been tried as alternatives to indomethacin in the patients intolerant to indomethacin. We report two cases of HC responsive to topiramate and review the available alternatives for the patients of HC. We also discuss the side effects of indomethacin in the various headache disorders and other painful conditions, and suggest the need for trial of other drugs for the patients of HC.
AuthorsSanjay Prakash, Mahammed Husain, Dhara S Sureka, Nimish P Shah, Nilima D Shah
JournalJournal of the neurological sciences (J Neurol Sci) Vol. 277 Issue 1-2 Pg. 187-90 (Feb 15 2009) ISSN: 0022-510X [Print] Netherlands
PMID19041987 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticonvulsants
  • Topiramate
  • Fructose
  • Indomethacin
Topics
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Anticonvulsants (therapeutic use)
  • Fructose (analogs & derivatives, therapeutic use)
  • Headache Disorders (drug therapy)
  • Humans
  • Indomethacin (therapeutic use)
  • Male
  • Middle Aged
  • Topiramate

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