Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review.
Hemicrania continua (HC) is a daily continuous unilateral headache of moderate intensity with super imposed exacerbations of more severe pain accompanied by migrainous and cranial autonomic features. Response to indomethacin is an essential feature in the IHS diagnostic criteria. However, indomethacin is associated with a number of side effects. HC is a life long condition, and skipping of a single dose of indomethacin usually leads to reappearance of headache. Various drugs have been tried as alternatives to indomethacin in the patients intolerant to indomethacin. We report two cases of HC responsive to topiramate and review the available alternatives for the patients of HC. We also discuss the side effects of indomethacin in the various headache disorders and other painful conditions, and suggest the need for trial of other drugs for the patients of HC.
Prakash
Sanjay
S
Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India. drprakashs@yahoo.co.in
Husain
Mahammed
M
Sureka
Dhara S
DS
Shah
Nimish P
NP
Shah
Nilima D
ND
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D020773:Headache Disorders / Q000188:drug therapy*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077236:Topiramate
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose; D007213:Indomethacin