Candesartan Gives Migraineurs New Hope: Study

cipsartan16mg

 

Candesartan seems to reduce incidences of migraines just as well as Propranolol (1)

Hope comes for migraineurs via a new study conducted by St. Olavs Hospital in Trondheim, Norway and the Norwegian University of Science and Technology. Migraine patients who have been prescribed propranolol, (a popular beta-blocker that also doubles up to reduce the number and severity of migraine episodes) as a migraine prophylactic but get no relief from taking it can now breathe a sigh of relief as the study demonstrates that chemical candesartan proves as if not more effective for migraine prophylaxis.

Though the theory of candesartan working as an effective migraine prophylactic had been propounded more than a decade ago, it has been proved only now that the drug actually works. In the study, the placebo administered showed a 20% ‘feel-better’ on patients but administering of candesartan exhibited an additional 20-30% patients’ ‘feel-better’. (2)

Candesartan is a blocker of the angiotensin II receptor. Angiotensin is a peptide hormone that constricts blood vessels causing the blood pressure to rise and the heart to pump blood harder. Blocking receptors that receive angiotensin hormone helps relax/dilate the blood vessels thereby lowering blood pressure and easing the heartbeat. (3)

The study which examined 72 migraineurs who had migraines at least twice every month, was a triple blind test in which neither neither patients nor doctors nor those who analyzed the results knew whether the patients had been given placebo or real medicine. The patients used each treatment (candesartan, propranolol or placebo) for 12 weeks, and also underwent four weeks before start and between the treatment periods without any medication at all. Thus every patient was part of the study for almost a year.

According to Professor Lars Jacob Stovner, leader of Norwegian National Headache Centre, “This gives doctors more possibilities and we can help more people.” (4)

Common side effects of candesartan are: dizziness, fatigue, abdominal discomfort, headache and reduced renal functions.

Atacand (AstraZeneca), Cipsartan (Cipla) are some popular brand names under which Candesartan is sold. Propranolol on the other hand is sold under the brand names Inderal, Inderal LA, InnoPran etc.

SOURCES

  1. Image Credit: Cipsartan-16 (Candesartan Cilexetil Tablets 16 mg) from Cipla; pharmacywebstore.com; Web January 2014; http://bit.ly/1aqwpIO
  2. New Hope for Migraine Sufferers; ScienceDaily.com; Web January 2014; http://sciencedaily.com/releases/2014/01/140113104841.htm
  3. Angiotensin II receptor blockers; Diseases and Conditions; Mayo Clinic; Web January 2014; http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/angiotensin-ii-receptor-blockers/art-20045009
  4. University of Science And Technology – News’ Web January 2014; http://www.ntnu.edu/news/2014/migraine-help

For more details of the study, please visit:

A Comparative Study Of Candesartan Versus Propranolol For Migraine Prophylaxis: A Randomised, Triple-Blind, Placebo-Controlled, Double Cross-Over Study; Sage Journals – Cephalagia; Web January 2014; http://cep.sagepub.com/content/early/2013/12/11/0333102413515348

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Drug Effectiveness & Power of Suggestion: Migraine Study

Role of Self Suggestions In Migraine

Doctor’s Words Affect Migraineurs’ Response To Drug (1)

A recent study conducted by researchers from Harvard Medical School and Beth Israel Deaconess Medical Center in Boston on migraineurs has shown that the type of labeling on the drug affects the body’s response to pain, nausea, photo-sensitivity, sound-sensitivity as well as vomiting (symptoms associated with a typical migraine attack).

According to Dr. Andrew Charles professor and director of the headache research and treatment program in the department of neurology at University of California School of Medicine, Los Angeles, who was not involved in the research, “When migraine patients were told by their doctor that a pill would help ease their headaches, this advice seemed to produce results whether or not the pill was a real migraine medication or a dummy placebo. Relief was still higher with the actual medicine, so drugs do work beyond the placebo effect, but the researchers say that the placebo effect may still account for half of the therapeutic value of a drug.” (2)

The research studied over 450 migraine attacks in total of 66 migraineurs over a period of their seven attacks.

  • The first attack was to go untreated but the migraineurs were expected to self-rate their pain and migraine-associated symptoms on a scale.
  • From the second attack up to the seventh attack the migraineurs were given medication (pills) in packets that were labelled.
  • The packets were labelled ‘Maxalt’ (Rizatriptan) – positive suggestion ( a drug that will help); ‘Placebo’ – a negative suggestion (drug with no effect on pain); ‘Maxalt or placebo’ – neutral suggestion (unknown if the drug will help or not).
  • But for two situations, one of the “Maxalt” envelopes actually held a placebo and one of the “placebo” envelopes contained Maxalt.
  • The migraineurs were to record the level of pain and discomfort 30 minutes from the onset of the migraine attack (for each of episode 2 through 7th episode)
  • Then they were to take the pills in the labelled packets.
  • Then they were to record their pain and discomfort two our thence ( A total of 2.5 hours after the commencement of a migraine attack)
  • In addition, they were also given a rescue medication in the event that the study medicines did not provide them with any relief. This rescue medication consisted of 1 Maxalt and 2 Naproxen tablets.
  • But for two situations, one of the “Maxalt” envelopes actually held a placebo and one of the “placebo” envelopes contained Maxalt.

Here is a chart depiction of the study methodology: (3)

Migraine Placebo Effect

As per Dr. Ted Kaptchuk, a senior author of the study, director of the Program in Placebo Studies, Beth Israel Deaconess Medical Center, and a professor of medicine at the Harvard Medical School, “We found that under each of the three messages, the placebo effect accounted for at least 50 percent of the subjects’ overall pain relief. When Maxalt was labelled “Maxalt,” the patients’ reports of pain relief more than doubled compared to when Maxalt was labeled “placebo.This tells us that the effectiveness of a good pharmaceutical may be doubled by enhancing the placebo effect.”

The authors were surprised to find that even when patients were given a placebo labeled as “placebo,” they reported pain relief, compared with no treatment. They had no idea why this occurred.

However, the findings of the study are best used for indicative purposes only and more research will be needed to be done to find out these results could be applied to clinical care and how placebos might help boost drug treatment care. As per Kaptchuk it is possible that simply hearing the words of medicine can have a healing effect, he noted.

SOURCES:

  1. Image Credit: Help Yourself Key Shows Self Improvement Online; Image by Stuart Miles; Freedigitalphotos.net; Web January 2014; http://www.freedigitalphotos.net/images/help-yourself-key-shows-self-improvement-online-photo-p211446
  2. Power of Suggestion Shown in Study of Migraine Drug; WebMD.com; January 2014; http://www.webmd.com/migraines-headaches/news/20140108/power-of-suggestion-revealed-in-study-of-migraine-drug
  3. Table Credit: Placebo effects are not the “power of positive thinking”; Science-Based Medicine; Web January 2014; http://www.sciencebasedmedicine.org/ted-kaptchuk-versus-placebo-effects-again/

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What Your Skin Temperature Could Tell About Your Migraine

 

Voila

Lower Temperatures At Body Extremities Could Indicate Migraine In Women (1)

A small scale study observing a women-only population of 41 Finnish women stated that skin temperatures in migraining women can be used as a bio-marker of vascular health since migraineurs are more at risk of developing cardiovascular diseases than healthy populations.

The study’s report published in Autonomic Neuroscience also observed that those with migraines usually have colder nose as well as hand and feet and that it could be attributed to abnormalities in the underlying blood vessels.

Here’s a quick look at the study statistics: (2)

  • Total women studied: 41
  • Those with migraines: 12; 10 with family history of migraines
  • Those without migraines: 29; 9 with family history of migraines

Out of the 12 migraining women 7 were found to experience right-sides migraines and 5 suffered the brunt of left-sided pains. The migraining population experienced visual aura. The study used digital infrared camera to measure skin temperatures in both migraining and control group. Temperatures of the cheeks, nose, forehead, fingertips and toes were taken for comparisons during headache-free periods.

The following results were obtained:

  • Women with right-sided migraines had higher blood pressure.
  • Women with right-sided migraines had lower hand and finger temperatures.
  • Compared to controls (healthy population) there was a 12 deg C (9 deg F) difference in temperatures at the fingertips and nose (extremities)

This could be explained by the fact that migraineurs often have constricted peripheral arteries or impaired functioning of the autonomic nervous system which in turn also makes them more susceptible to cardiovascular diseases.

The average temperature of the nose and hands was about 16 deg C (approx 3.6 degrees F) lower in migraine subjects than controls. Of the migraine patients, 58% had skin temperatures below 30 deg C (or 86 deg F), which is considered a normal skin temperature, in both the nose and fingers.

However, it must be noted that this study was not only small sized but also did not include men. Larger population studies including men and other ethnic groups should be conducted to come to a definitive conclusion. It however, does provide some indication to the direction in which medication development can be done. Biofeedback as an alternative medical therapy makes use of this skin temperature differential in migraineurs to manage pain episodes.

 SOURCES

  1. Image Credit: Business Woman Worried Stock Photo; freedigitalphotos.net; Web January 2014; http://www.freedigitalphotos.net/images/Business_People_g201-Business_Woman_Worried_p76375.html
  2. The Connection Between Migraines and Skin Temperature; The Wall Street Journal; Web January 2013; http://online.wsj.com/news/articles/SB10001424052702303497804579242423379994080

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Happy New Year, Stay Blessed!!

Happy New Year

 

Wishing all Migraines-In-Women readers a very very happy new year! May health and joy be yours in 2014!

 

Image Credits:

Balloons In The Sky Saying Happy New Year Stock Image By Stuart Miles, published on 09 June 2013; Stock Image – image ID: 100175154; Freedigitalphotos.net; Web January 2014;  http://www.freedigitalphotos.net/images/balloons-in-the-sky-saying-happy-new-year-photo-p175154

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