Enkephalinase inhibition relieves pain syndromes of central dysnociception (migraine and related headache).
Normotensive and hypertensive headache sufferers were treated with D-phenylalanine, aprotinin or captopril--all inhibitors of endogenous opioid degradation. Inconsistent results were obtained using D-phenylalanine and aprotinin (acute administration at the start of a migraine attack). Satisfactory results were obtained by prophylactic treatment with captopril (an inhibitor of the angiotensin converting enzyme and of the dipeptidyl carboxypeptidase--an enkephalin inactivating enzyme) compared with conventional drugs such as methysergide, lisuride, pizotifen, clonidine and beta-blocking agents. Excellent results were obtained with captopril on patients suffering from headache and arterial hypertension who had experienced no relief from beta-blocking agents and clonidine. Captopril could thus be a drug of choice in the therapy of headache associated with essential hypertension.
D000208:Acute Disease; D000328:Adult; D000818:Animals; D007611:Aprotinin / Q000627:therapeutic use*; D001920:Bradykinin / Q000502:physiology; D002216:Captopril / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004878:Ergotamine / Q000627:therapeutic use; D005260:Female; D006168:Guinea Pigs; D006261:Headache / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D051379:Mice; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D015260:Neprilysin; D010146:Pain / Q000188:drug therapy; D010649:Phenylalanine / Q000627:therapeutic use*; D011392:Proline / Q000031:analogs & derivatives*; D011480:Protease Inhibitors
D011480:Protease Inhibitors; D010649:Phenylalanine; D007611:Aprotinin; D011392:Proline; D002216:Captopril; D015260:Neprilysin; D004878:Ergotamine; D001920:Bradykinin