Refractory CH abated with treatment with warfarin - 1st case

Annette

This is the first case report of a person with refractory ( ie med resistant ) chronic CH for 6 years finding relief with treatment of warfarin, incidentally, for something not related ( deep vein thrombosis ).

Below is an excerpt and the link to the whole article

REMISSION OF REFRACTORY CHRONIC CLUSTER
HEADACHE AFTER WARFARIN ADMINISTRATION

Case report

DISCUSSION

In the present case, it is necessary to consider the
possibility of coincidence, but the patient had presented
cluster headache crises for more than six
years, with no effective control, spite of being in use
of suitable medications. With the use of warfarin and
achievement of INR 2.5, there was the remission of
crises. When it was necessary to replace warfarin with
heparin, the crises returned and, once more, they
have ceased with the return to oral anticoagulant.
An important datum is that the patient was a
smoker, and consumed about 20 cigarettes a day,
and the relief during the first hospital admission
could be attributed to the smoking habit interruption.
However, during the second hospital admission,
when the warfarin suspension produced the
return of crises, the patient had not smoked for
months and the crises remitted only when the use
of warfarin was returned.
Our evaluation is that, as it occurs for some patients
with migraine, warfarin may have a preventive
effect on the cluster headache.
This is the first case in the literature, as far as
we know, of a patient with chronic cluster headache
refractory to treatment presentig complete remission
of the crises following administration of warfarin
for another purpose.

Link to the whole article
http://www.scielo.br/pdf/anp/v62n4/a29v62n4.pdf

Ike

thanx nice post.

I cant take warfarin wish i could, i think phil takes it tho

Annette

Found this :

" Vitamin K is known to have a role in the central nervous system (CNS), inducing nitric oxide (NO), another chemical compound which can cause blood vessels to dilate. These compounds, as previously stated, may play a role in triggering the onset of a headache attack. The link between warfarin and its utility in cluster headaches may be through this mechanism. Kowacs et al. suggested that if warfarin can decrease vitamin K in the CNS, it may also decrease NO, leading to less vasodilation, and raising the threshold needed to trigger a headache attack. 1, 3 Warfarin has also been suggested to trigger or potentiate cluster headache attacks. 2 This article of case reports, however failed to propose a mechanism by which warfarin may have caused these attacks. Nevertheless, warfarin utility in this disease remains to be fully seen. "

This is from

[url]http://www.warfarinfo.com/headaches.htm [/url]

Annette

Found further cases

Warfarin as a therapeutic option in the control of chronic cluster headache: a report of three cases

Journal The Journal of Headache and Pain

Abstract
Chronic cluster headache remains refractory to medical therapy in at least 30% of those who suffer from this condition. The lack of alternative medical therapies that are as effective as, or more effective than, lithium carbonate makes new therapies necessary for this highly disabling condition. Based on a previous report, we gave oral anticoagulants to three patients with chronic cluster headache. Two of them remained cluster headachefree while taking warfarin. In the third patient, the use of warfarin for three weeks initially increased the frequency and intensity of cluster headache attacks but subsequently induced a prolonged remission. In spite of the paucity of data available, oral anticoagulation appears to be a promising therapy for chronic cluster headache.

[url]http://www.springerlink.com/content/hut2r8w77686527u/ [/url]

Ike

anyone here tried Warfarin ? i think you take it phil, does it help at all ?

has anyone else taken it ?

Annette

I asked Phil , he has never taken warfarin.

I dont know of anyone else already on warfarin. I asked on ch.com but no one has posted saying that they are on it.

Ike

stand corrected phil was on wellbutrin my bad