Conflict of Interest: Dr. Young has worked in an advisory capacity for GlaxoSmithKline and Allergan but does not believe he has any conflict of interest in this case. Mr. Milo Hollingworth does not have any conflict of interest in this case.
Melatonin Responsive Hemicrania Continua in Which Indomethacin Was Associated With Contralateral Headache
Article first published online: 21 NOV 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 54, Issue 5, pages 916–919, May 2014
How to Cite
Hollingworth, M. and Young, T. M. (2014), Melatonin Responsive Hemicrania Continua in Which Indomethacin Was Associated With Contralateral Headache. Headache: The Journal of Head and Face Pain, 54: 916–919. doi: 10.1111/head.12270
- Issue published online: 2 MAY 2014
- Article first published online: 21 NOV 2013
- Manuscript Accepted: 9 OCT 2013
- hemicrania continua;
- indomethacin-resistant hemicrania continua
Headache is a well-documented side effect of indomethacin in the older medical literature; however, it has rarely been commented on in indomethacin-responsive hemicrania continua. We describe the case of a 60-year-old woman with left-sided hemicrania continua whose indomethacin treatment was associated with a continuous right-sided migraine. Her indomethacin therapy was discontinued heralding a return of her left-sided hemicrania continua and a resolution of her right-sided migraine. Her hemicrania continua then responded well to melatonin, with recurrence on stopping and improvement on restarting. This is the most detailed description of headache as a side effect of indomethacin in a headache patient we are aware of, and one of only a few reported cases of melatonin-responsive hemicrania continua. We review the evidence of headache as a side effect of indomethacin in order to highlight its importance in the treatment of headache disorders. We emphasize that indomethacin headache response may be more than simply a beneficial or neutral one and might be relevant to some cases of apparently indomethacin-resistant hemicrania continua. We hope this case may encourage clinicians to inquire about headache as a potential side effect of indomethacin.