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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(09): 620-624
DOI: 10.1590/0004-282X20170119
ARTICLES

Clomiphene treatment may be effective in refractory episodic and chronic cluster headache

Tratamento de 15 casos episódicos e crçnicos de cefaleia em salvas de difícil controle com clomifeno
Maria Eduarda Nobre
1   Universidade Federal Fluminense, Departamento de Neurologia, Niterói RJ, Brasil;
,
Mario Fernando Prieto Peres
2   Hospital Albert Einstein, Departamento de Neurologia, São Paulo SP, Brasil;
,
Pedro Ferreira Moreira Filho
1   Universidade Federal Fluminense, Departamento de Neurologia, Niterói RJ, Brasil;
,
Antonio José Leal
3   Universidade Federal do Rio de Janeiro, Departamento de Epidemiologia, Rio de Janeiro RJ, Brasil.
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ABSTRACT

Objective To describe the evolution of 15 patients who were treated for difficult-to-control episodic and chronic cluster headaches with clomiphene.

Methods Clomiphene treatment was used for seven chronic and eight episodic cluster headache patients. The chronic patients were refractory to the medication being used, and the episodic patients, in addition to being resistant to conventional medication, had longer cluster headache periods, exceeding the average time of previous cluster cycles. Our main analysis was of the time to pain-free, complete remission, and the length of pain-free time and complete remission.

Results Clomiphene was used for 45-180 days. The average time to being pain-free was 15 days and cluster remission was up to 60 days. The average time between being pain-free until cluster remission was 26 days.

Conclusions Clomiphene treatment was significantly efficient. It interrupted chronicity in all patients, suggesting the capability of changing the pattern of attacks. It proved to be safe and well tolerated.

RESUMO

Objetivo Descrever a evolução de 15 casos de cefaleia em salvas de difícil controle, episódicos e crçnicos, tratados com clomifeno.

Métodos Foram tratados 7 casos crçnicos e 8 episódicos. Os crçnicos, refratários aos medicamentos preventivos em uso e os episódicos, além de refratários, apresentaram salva mais longa que as anteriores. Foram analisados o tempo para a ausência das crises, fim da salva e o tempo entre os dois parâmetros.

Resultados O clomifeno foi usado por 45 a 180 dias. A média de tempo para a remissão das crises foi de 15 dias e da salva foi de 60 dias. A média entre o fim das crises e da salva foi de 26 dias.

Conclusão O clomifeno foi eficaz em ambos os padrões. Foi capaz de interromper a cronicidade em todos os casos, o que sugere uma ação neuromodulatória capaz de mudar o padrão das crises. Mostrou-se seguro e bem tolerado.

headache - therapeutics - testosterone - clomiphene - hypothalamus
cefaleia - terapêutica - testosterona - clomifeno - hipotálamo


Publication History

Received: 23 April 2017

Accepted: 27 June 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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