Effect of low-intensity acenocoumarol on frequency and severity of migraine attacks.
OBJECTIVE
To investigate the effect of low-intensity acenocoumarol treatment (target INR 1.5 to 2.0) on the frequency and severity of migraine attacks.


BACKGROUND
The positive effect of anticoagulation on migraine has been described in case reports and observational studies.


METHODS
We conducted a randomized, open, crossover study in migraine patients. After a run-in period of 8 weeks, all patients received acenocoumarol or propranolol during a period of 12 weeks and, after a washout period of 2 weeks, propranolol or acenocoumarol during a second period of 12 weeks.


RESULTS
Nineteen patients fulfilling the criteria were included. In 12 patients with complete data collection, only one good responder could be noted. In the other patients, treatment with low-intensity acenocoumarol did not show improvement of migraine symptoms compared with the run-in period. Treatment with propranolol showed a trend towards improvement compared with the run-in period. No serious adverse events were observed.


CONCLUSIONS
Overall, low-intensity acenocoumarol treatment has no prophylactic effect in migraine patients.
Wammes-van der Heijden
Elisabeth A
EA
Utrecht Institute for Pharmaceutical Sciences, Pharmacoepidemiology and Pharmacotherapy, Utrecht, The Netherlands.
Smidt
Martijn H
MH
Tijssen
Cees C
CC
van't Hoff
Annelies R
AR
Lenderink
Albert W
AW
Egberts
Antoine C G
AC
D000074:Acenocoumarol / Q000627:therapeutic use*; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000517:prevention & control*; D011433:Propranolol / Q000627:therapeutic use; D016896:Treatment Outcome
D000925:Anticoagulants; D011433:Propranolol; D000074:Acenocoumarol