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Indomethacin-responsive headaches-A narrative review.
Maria Dolores Villar-Martínez1,2, David Moreno-Ajona1,2, Calvin Chan1
1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Headache
|June 9, 2021
Summary
Indomethacin effectively treats specific headache disorders, though its exact mechanism remains unclear. Research suggests its action involves cerebral blood flow and nitrergic pathways, aiding understanding of these conditions.
Area of Science:
- Neurology
- Pharmacology
Background:
- Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), is known for its efficacy in specific headache disorders.
- The precise mechanism of action for indomethacin in these conditions is not fully understood.
- Indomethacin-responsive headaches, including hemicrania continua and paroxysmal hemicrania, exhibit a distinct therapeutic response.
Purpose of the Study:
- To review the pharmacokinetic and pharmacodynamic properties of indomethacin.
- To explore proposed mechanisms of action for indomethacin in responsive headache disorders.
- To summarize current evidence for indomethacin's use in primary and secondary headaches.
Main Methods:
- A narrative literature review was conducted.
- Searches were performed using PubMed and the Cochrane databases.
Main Results:
- The review covers indomethacin's pharmacokinetic and pharmacodynamic profiles relevant to clinical practice.
- Proposed mechanisms include effects on cerebral blood flow, intracranial pressure, and nitrergic pathways.
- Evidence for indomethacin in primary headaches (e.g., trigeminal autonomic cephalalgias, migraine) and secondary headaches (e.g., post-traumatic) is presented.
Conclusions:
- Understanding indomethacin's mechanisms can illuminate the pathophysiology of indomethacin-sensitive headaches.
- Further research into these mechanisms may reveal shared pathways among these distinct headache disorders.
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