Headache
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Randomized Controlled Trial Multicenter Study Comparative Study
OTC analgesics in headache treatment: open-label phase vs randomized double-blind phase of a large clinical trial.
To compare the superior efficacy of the fixed combination of acetylsalicylic acid, paracetamol, and caffeine over the single substances, which was observed in the randomized, double-blind phase of the clinical trial, with the efficacy of the respective usual nonprescription medication taken by the patients in the open-label pre-phase of the same study. ⋯ Time course of PID after intake of the patient's usual medication was very similar to the time course of PID after intake of the randomized study medication. After 2 hours, pain reduction was on average 43.0, 38.2, 38.1, and 37.7 mm as assessed on the visual analog scale in the group of patients who took their usual triple combination containing acetylsalicylic acid, paracetamol, and caffeine, the single agents acetylsalicylic acid, paracetamol, and ibuprofen, respectively, in the open-label phase. The corresponding mean pain reduction was 44.7, 40.7, and 39.5 mm in patients allocated to the triple combination containing acetylsalicylic acid, paracetamol, and caffeine, the single agents acetylsalicylic acid, and paracetamol, respectively, in the randomized, double-blind phase.
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This study examined modulation of trigeminal pain/nociception by 2 supraspinal mechanisms: emotional controls of nociception and diffuse noxious inhibitory controls. ⋯ Emotional controls and diffuse noxious inhibitory controls modulated trigeminal pain and emotional controls modulated trigeminal nociception. These procedures can be used to study supraspinal modulation of nociceptive processing in disorders of the trigeminal pain system, including headache.
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Randomized Controlled Trial Multicenter Study
Rizatriptan 10-mg ODT for early treatment of migraine and impact of migraine education on treatment response.
To examine the efficacy of rizatriptan 10-mg orally disintegrating tablet (ODT) for treating migraines of mild intensity soon after onset, with or without patient-specific migraine education. ⋯ Rizatriptan 10-mg ODT, when taken early, while headache pain is mild, was superior to placebo at providing pain freedom at 2 hours and 24-hour sustained pain freedom.
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The primary purpose of this study was to explore the feasibility and acceptability of using an Internet-based headache diary to obtain acceptable completion rates of daily diaries. ⋯ The Internet-based headache diary is a feasible, acceptable data collection tool that can access geographically diverse populations who have not previously participated in research studies. Use of an Internet-based approach was found to be feasible for recruitment and retention of such diverse populations.
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Case Reports
Can indomethacin act as a disease modifying agent in hemicrania continua? A supportive clinical case.
The natural history of hemicrania continua (HC) is not well-known. Most sufferers have the unremitting form and thus may have a lifetime duration of pain. ⋯ The question arises: Does indomethacin have disease-modifying capacities for HC or does it just suppress the pain without altering the underlying disease pathogenesis? A case patient is presented who had indomethacin-responsive unremitting HC and after a period of daily use of indomethacin she was able to reduce her dose to one single 25-mg tablet 3 days per week and still remain pain free, suggesting disease modification. The case patient's history will be further discussed as well as the consideration that in some instances indomethacin can alter the natural history of HC.