title: Warfarin as a therapeutic option in the control of chronic cluster headache: a report of three cases.
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 headache-free 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.
authors.affiliation: Headache Section, Neurology Division, Internal Medicine Department, Hospital de Clínicas, Universidade Federal do Paraná, Rua General Carneiro 181/1236, 80060-900 Curitiba, Brazil. cefaleia@hc.ufpr.br
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Kowacs
authors.forename: Elcio J
authors.initials: EJ
authors.lastname: Piovesan
authors.forename: Ricardo W G R
authors.initials: RW
authors.lastname: de Campos
authors.forename: Marcos C
authors.initials: MC
authors.lastname: Lange
authors.forename: Viviane Flumingham
authors.initials: VF
authors.lastname: Zetola
authors.forename: Lineu C
authors.initials: LC
authors.lastname: Werneck
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001921:Brain / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D003027:Cluster Headache / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D004660:Encephalitis / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome; D014278:Trigeminal Nuclei / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D014812:Vitamin K / Q000096:biosynthesis; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin