Migraine with skin sensitivity eased by older drug

NEW YORK (Reuters Health) - Dihydroergotamine or DHE, an established drug for migraine, works well even when the attack is accompanied by super-sensitivity to touch or heat and cold, according to researchers.

Many migraine sufferers get relief from the newer drugs known as triptans, but these are less effective when people also have heightened skin sensitivity. This condition, called cutaneous allodynia, makes even a light touch to the face or neck feel painful.

“Unlike triptans, DHE works in the presence of allodynia, any time in the migraine attack,” lead investigator Dr. Stephen D. Silberstein told Reuters Health.

Silberstein and colleagues at Thomas Jefferson University, Philadelphia came to this conclusion after a pilot study involving nine patients. All had episodic migraine associated with cutaneous allodynia.

They were treated on two occasions with an injection of DHE, once within 2 hours of the start of throbbing pain and once after the migraine had been going on for 4 hours.

Regardless of treatment time, five of the patients had a significant reduction in headache pain within 2 hours, and four were headache-free within 8 hours of being given DHE, the investigators report in the medical journal Headache.

Cutaneous allodynia started to decline 30 minutes after early treatment and 120 minutes after late treatment.

Overall, six of the patients reported at least one mild to moderate side effect, most often a burning sensation at the injection site.

The investigators point out that “the results of this pilot trial provide proof of concept” for the benefit of DHE. “These findings must be regarded as preliminary, and a larger, placebo-controlled clinical trial is warranted.”

SOURCE: Headache, June 2007.