Related Experiment Video

Updated: Jun 23, 2026

Induction of Ocular Surface Inflammation and Collection of Involved Tissues
06:38

Induction of Ocular Surface Inflammation and Collection of Involved Tissues

Published on: August 4, 2022

Can indomethacin act as a disease modifying agent in hemicrania continua? A supportive clinical case

Todd D Rozen1

  • 1Neurology, Michigan Head Pain and Neurological Institute, Ann Arbor, MI 48104, USA.

Headache
|May 22, 2009
PubMed

Insights

Hemicrania continua (HC) may be modified by indomethacin treatment, potentially altering its long-term course. This suggests indomethacin might do more than just manage pain in some HC patients.

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Hemicrania continua (HC) is a rare headache disorder with an often unremitting, lifelong course.
  • The natural history and long-term effects of treatments for HC remain poorly understood.
  • Prolonged indomethacin use, a common treatment, carries risks of significant medical morbidity.

Observation:

  • A case of indomethacin-responsive hemicrania continua is presented.
  • The patient achieved sustained pain freedom with a significantly reduced indomethacin dosage after initial daily use.
  • This reduction suggests a potential disease-modifying effect beyond simple analgesia.

Findings:

  • Indomethacin's role in hemicrania continua may extend beyond symptomatic pain relief.
  • Evidence suggests indomethacin could potentially alter the underlying disease process in some HC cases.
  • This challenges the notion that indomethacin only suppresses pain without affecting HC pathogenesis.

Implications:

  • Further research into indomethacin's disease-modifying potential in HC is warranted.
  • Understanding this effect could lead to revised treatment strategies and improved long-term patient outcomes.
  • This case highlights the possibility of altering the natural history of hemicrania continua with targeted pharmacotherapy.

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Cholinergic Antagonists: Therapeutic Uses01:26

Cholinergic Antagonists: Therapeutic Uses

Antimuscarinic drugs have various therapeutic applications by inhibiting parasympathetic stimulation in different systems. Here are the key therapeutic uses of antimuscarinics:    
Respiratory Tract: Ipratropium, aclidinium, and tiotropium treat asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). They protect against bronchoconstriction caused by irritants like cigarette smoke, sulfur dioxide, and ozone. They also help reduce nasopharyngeal secretions in common...