Tag Archives: Methysergide

Preventive Treatment for Migraine

Migraine is a common episodic headache disorder characterized by attacks that consist of various combinations of headache and neurologie, gastrointestinal, and autonomie symptoms. It has a one-year prevalence of approximately 18% in women, 6% in men, and 4% in children. The second edition of the International Classification of Headache Disorders (ICHD-2) subclassifies migraine into migraine… Read More »

Specific Migraine-Preventive Agents: Serotonin Antagonists

The antiserotonin, migraine-preventive drugs are potent 5-HT2B- and 5-HT2C-receptor antagonists, whereas metachlorophenyl piperazine (mCPP), a 5-HT2B- and 5-HT2C-receptor agonist, induces migraine in susceptible individuals. Methysergide, cyproheptadine, and pizotifen, effective migraine prophylactic drugs, are 5-HT2B-and 5-HT2C-receptor antagonists, whereas ketanserin, a selective 5-HT2A- and a poor 5-HT2B- and 5-HT2C-receptor antagonist, is not. mCPP, a major metabolite of… Read More »

Specific Migraine-Preventive Agents: Calcium-Channel Antagonists

Calcium, in combination with a calcium-binding protein such as calmodulin or troponin, regulates many functions, including muscle contraction, neurotransmitter and hormone release, and enzyme activity. Its extracellular concentration is high; its intracellular free concentration is 10,000-fold smaller. The concentration gradient is established by membrane pumps and the intracellular sequestering of free calcium. When stimulated, the… Read More »


Headache which is not due to intracranial or systemic pathology is described as primary headache. Primary headaches are appropriately treated in the pain clinic, whereas secondary headaches require investigation. Diagnosis is made by history. Examination and investigations may be necessary to exclude secondary headache. Diagnostic criteria have been defined by the Headache Classification Committee of… Read More »

Drugs used for prevention of chronic headaches used during pregnancy…

Match the medication used for prevention of chronic headaches with the potential fetal complication if used during pregnancy. Each answer may be used once, more than once, or not at all. A. Propranolol (Inderal) B. Topiramate (Topamax) C. Lisinopril (Prinivil) D. Methysergide (Sansert) E. Divalproex sodium 1. Intrauterine growth retardation 2. Spina bifida 3. Hypospadias… Read More »

Which of the treatments is the best short-term prevention for CHs?

Which of the following available treatments is the best short-term prevention for CHs? A. Steroids B. Injectable sumatriptan (Imitrex) C. Oxygen inhalation D. Intranasal lidocaine E. Methysergide (Sansert) The answer is A. Oral steroids are the most effective short-term preventa-tive therapy for CH. They may be used while the doses of long-term preventative medications, such… Read More »


Several types of headaches are unique to sleep and its disorders. Thus, evaluation of headache should also include temporal information during the 24-hour cycle, which may offer clues to the diagnosis. Key headaches that are classically associated with sleep include cluster headaches, migraines, chronic paroxysmal hemicrania, and hypnic headaches. Additionally, sleep apnea can help trigger… Read More »

Principles of management

The management of major depressive disorder (major depressive disorder) involves establishing a correct diagnosis and applying evidence based and goal directed principles of treatment. These treatment principles include recognizing and treating any coexisting medical conditions, building a therapeutic alliance with patients and choosing an appropriate treatment, as well as monitoring and maintaining response (Table Nine… Read More »