Skip to main content

Advertisement

SpringerLink
Log in

Neuromodulators for the treatment of headache disorders and fibromyalgia

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Migraine and fibromyalgia are prevalent and disabling disorders with few preventive medications approved by the US Food and Drug Administration (FDA). Neuromodulators (or antiepileptic drugs; AEDs) are often effective in the treatment of these conditions. Divalproex sodium and topiramate are FDA-approved AEDs for migraine. For fi bromyalgia, pregabalin has recently been approved in the United States. We review the use of AEDs in the preventive treatment of these highly prevalent disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Stewart WF, Lipton RB, Celentano BB, Reed ML: Prevalence of migraine headache in the United States. Relation to age, income, race, and other socioeconomic factors. JAMA 1992, 267:64–69.

    Article  PubMed  CAS  Google Scholar 

  2. Lipton RB, Bigal ME, Diamond M, et al.: Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007, 68:343–349.

    Article  PubMed  CAS  Google Scholar 

  3. Silberstein SD, Rosenberg J: Multispecialty consensus on diagnosis and treatment of headache. Neurology 2000, 54:1553.

    PubMed  CAS  Google Scholar 

  4. Capobianco DJ, Cheshire WP, Campbell JK: An overview of the diagnosis and pharmacologic treatment of migraine. Mayo Clin Proc 1996, 71:1055–1066.

    Article  PubMed  CAS  Google Scholar 

  5. Silberstein SD: Topiramate in migraine prevention. Headache 2005, 45 (Suppl 1):S57–S65.

    Article  Google Scholar 

  6. Bigal ME, Krymchantowski AV, Rapoport AM: New developments in migraine prophylaxis. Expert Opin Pharmacother 2003, 4:433–443.

    Article  PubMed  CAS  Google Scholar 

  7. Wolfe F, Ross K, Anderson J, et al.: The prevalence and characteristics of fi bromyalgia in the general population. Arthritis Rheum 1995, 38:19–28.

    Article  PubMed  CAS  Google Scholar 

  8. Staud R, Rodriguez ME: Mechanisms of disease: pain in fi bromyalgia syndrome. Nat Clin Pract Rheumatol 2006, 2:90–98.

    Article  PubMed  Google Scholar 

  9. Wolfe F, Smythe HA, Bennett RM, et al.: The American College of Rheumatology 1990 Criteria for the Classifi cation of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990, 33:160–172.

    Article  PubMed  CAS  Google Scholar 

  10. Prodinger B, Cieza A, Williams DA, et al.: Measuring health in patients with fi bromyalgia: content comparison of questionnaires based on the International Classifi cation of Functioning, Disability, and Health. Arthritis Rheum 2008, 59:650–658.

    Article  PubMed  Google Scholar 

  11. Owen RT: Pregabalin: its effi cacy, safety, and tolerability profi le in fi bromyalgia syndrome. Drugs Today 2007, 43:857–863.

    PubMed  CAS  Google Scholar 

  12. Nymdelger S, Nieber K: Pregabalin—a neuromodulator for the treatment of neuropathic pain, generalized anxiety disorders, and fi bromyalgia syndrome. Med Monatsschr 2007, 30:396–400.

    CAS  Google Scholar 

  13. Arnold LM: Duloxetine and other antidepressants in the treatment of patients with fi bromyalgia. Pain Med 2007, 8 (Suppl 2):S63–S74.

    Article  Google Scholar 

  14. Goldenberg DL: Pharmacological treatment of fi bromyalgia and other chronic musculoskeletal pain. Best Pract Res Clin Rheumatol 2007, 21:499–511.

    Article  PubMed  CAS  Google Scholar 

  15. Wood PB, Holman AJ, Jones KD: Novel pharmacotherapy for fi bromyalgia. Expert Opin Investig Drugs 2007, 16:829–841.

    Article  PubMed  CAS  Google Scholar 

  16. Arnold LM, Goldenberg DL, Stanford SB, et al.: Gabapentin in the treatment of fi bromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007, 56:1336–1344.

    Article  PubMed  CAS  Google Scholar 

  17. Arnold LM: Duloxetine and other antidepressants in the treatment of patients with fi bromyalgia. Pain Med 2007, 8 (Suppl 2):S63–S74.

    Article  Google Scholar 

  18. Haan J, Terwindt GM, Bos PL, et al.: Familial hemiplegic migraine in The Netherlands. Clin Neurol Neurosurg 1994, 96:244–249.

    Article  PubMed  CAS  Google Scholar 

  19. Leao AAP: Spreading depression of activity in cerebral cortex. J Neurophysiol 1944b, 7:359–390.

    Google Scholar 

  20. Moskowitz MA: Basic mechanisms in vascular headache. Neurol Clin 1990, 8:801–815.

    PubMed  CAS  Google Scholar 

  21. Moskowitz MA, Nozaki K, Kraig RP: Neocortical spreading depression provokes the expression of C-fos protein-like immunoreactivity within the trigeminal nucleus caudalis via trigeminovascular mechanisms. J Neurosci 1993, 13:1167–1177.

    PubMed  CAS  Google Scholar 

  22. Weiller C, May A, Limmroth V, et al.: Brain stem activation in spontaneous human migraine attacks. Nat Med 1995, 1:658–660.

    Article  PubMed  CAS  Google Scholar 

  23. Afridi S, Matharu MS, Lee L, et al.: A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate. Brain 2005b, 128:932–939.

    Article  PubMed  CAS  Google Scholar 

  24. Rao SG, Gendreau JF, Kranzler JD: Understanding the fi bromyalgia syndrome. Psychopharmacol Bull 2007, 40:24–67.

    PubMed  Google Scholar 

  25. Staud R, Vierck CJ, Robinson ME, Price DD: Effects of the N-methyl-D-aspartate receptor antagonist dextromethorphan on temporal summation of pain are similar in fi bromyalgia patients and normal control subjects. J Pain 2005, 6:323–332.

    Article  PubMed  CAS  Google Scholar 

  26. Crofford LJ, Pillemer SR, Kalogeras KT, et al.: Hypothalamic-pituitary-adrenal axis perturbations in patients with fi bromyalgia. Arthritis Rheum 1994, 37:1583–1592.

    Article  PubMed  CAS  Google Scholar 

  27. Wolfe F, Russell IJ, Vipraio G, et al.: Serotonin levels, pain threshold, and fi bromyalgia symptoms in the general population. J Rheumatol 1997, 24:555–559.

    PubMed  CAS  Google Scholar 

  28. Wood PB, Patterson JC, Sutherland JJ, et al.: Reduced presynaptic dopamine activity demonstrated with positron emission tomography: a pilot study. J Pain 2007, 8:51–58.

    Article  PubMed  CAS  Google Scholar 

  29. Bigal ME, Bordini CA, Tepper SJ, Speciali JG: Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura. A randomized, double-blind, placebo-controlled study. Cephalalgia 2002, 22:345–353.

    Article  PubMed  CAS  Google Scholar 

  30. Russell IJ, Michalek JE, Flechas JD, Abraham GE: Treatment of fi bromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol 1995, 22:953–958.

    PubMed  CAS  Google Scholar 

  31. Mathew NT: Migraine prophylaxis with divalproex. Arch Neurol 1995, 52:281–286.

    PubMed  CAS  Google Scholar 

  32. Tringali G, Aubry JM, Moscianese K, et al.: Valproic acid inhibits corticotropin-releasing factor synthesis and release from the rat hypothalamus in vitro: evidence for the involvement of GABAergic neurotransmission. J Psychiatry Neurosci 2004, 29:459–466.

    PubMed  Google Scholar 

  33. Mathew NT: Intravenous valproate sodium aborts migraine rapidly: a preliminary report. Headache 2000, 40:720–723.

    Article  PubMed  CAS  Google Scholar 

  34. Ramadan NM: Prophylactic migraine therapy: mechanisms and evidence. Curr Pain Headache Rep 2004, 8:91–95.

    Article  PubMed  Google Scholar 

  35. Silberstein SD: Divalproex sodium in headache—literature review and clinical guidelines. Headache 1996, 36:547–555.

    Article  PubMed  CAS  Google Scholar 

  36. Silberstein SD, Neto W, Schmitt J, et al.: Topiramate in migraine prevention: results of a large controlled trial. Arch Neurol 2004, 61:490–495.

    Article  PubMed  Google Scholar 

  37. Sigel E: Functional modulation of ligand-gated GABAA and NMDA receptor channels by phosphorylation. J Recept Signal Transduct Res 1995, 15:325–332.

    Article  PubMed  CAS  Google Scholar 

  38. Adelman J, Freitag FG, Lainez M, et al.: Analysis of safety and tolerability data obtained from over 1,500 patients receiving topiramate for migraine prevention in controlled trials. Pain Med 2008, 9:175–185.

    Article  PubMed  Google Scholar 

  39. Brandes JL, Saper J, Diamond M, et al.: Topiramate for migraine prevention: a randomized controlled trial. JAMA 2004, 291:965–973.

    Article  PubMed  CAS  Google Scholar 

  40. Mathew NT, Rapoport A, Saper J, et al.: Effi cacy of gabapentin in migraine prophylaxis. Headache 2001, 41:119–128.

    Article  PubMed  CAS  Google Scholar 

  41. Freitag FG, Diamond S, Diamond ML, et al.: The prophylaxis of migraine with the GABA-agonist, tiagabine: a clinical report [abstract]. Headache 1999, 39:354.

    Google Scholar 

  42. Kaniecki R: Neuromodulators for migraine prevention. Headache 2008, 48:586–600.

    Article  PubMed  Google Scholar 

  43. Crofford LJ, Rowbotham MC, Mease PJ, et al.: Pregabalin for the treatment of fi bromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2005, 52:1264–1273.

    Article  PubMed  CAS  Google Scholar 

  44. Gajraj NM: Pregabalin for pain management. Pain Pract 2005, 5:95–102.

    Article  PubMed  Google Scholar 

  45. Peres MF, Zukerman E, Senne Soares CA, et al.: Cerebrospinal fl uid glutamate levels in chronic migraine. Cephalalgia 2004, 24:735–739.

    Article  PubMed  CAS  Google Scholar 

  46. Sarchielli P, Mancini ML, Floridi A, et al.: Increased levels of neurotrophins are not specifi c for chronic migraine: evidence from primary fi bromyalgia syndrome. J Pain 2007, 8:737–745.

    Article  PubMed  CAS  Google Scholar 

  47. Arnold LM, Crofford LJ, Martin SA, et al.: The effect of anxiety and depression on improvements in pain in a randomized, controlled trial of pregabalin for treatment of fi bromyalgia. Pain Med 2007, 8:633–638.

    Article  PubMed  Google Scholar 

  48. Nymdelger S, Nieber K: Pregabalin—a neuromodulator for the treatment of neuropathic pain, generalized anxiety disorders, and fi bromyalgia syndrome. Med Monatsschr Pharm 2007, 30:396–400.

    PubMed  CAS  Google Scholar 

  49. Arnold LM, Goldenberg DL, Stanford SB, et al.: Gabapentin in the treatment of fi bromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007, 56:1336–1344.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Merck Research Laboratories, 1 Merck Drive, Whitehouse Station, NJ, 08889, USA

    Marcelo E. Bigal

Authors
  1. Abouch V. Krymchantowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Juline Bryson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard B. Lipton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcelo E. Bigal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcelo E. Bigal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krymchantowski, A.V., Bryson, J., Lipton, R.B. et al. Neuromodulators for the treatment of headache disorders and fibromyalgia. Current Science Inc 12, 333–337 (2008). https://doi.org/10.1007/s11916-008-0056-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-008-0056-8

Keywords

Search

Navigation