From the Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht (Dr. Wammes-van der Heijden); the Department of Neurology, St. Elisabeth Hospital, Tilburg (Dr. Tijssen); Thrombosis Services (Dr. van't Hoff) and the Hospital Pharmacy (Prof. Dr. Egberts), Midden-Brabant, Tilburg; The Netherlands.
A Thromboembolic Predisposition and the Effect of Anticoagulants on Migraine
Article first published online: 7 MAY 2004
Headache: The Journal of Head and Face Pain
Volume 44, Issue 5, pages 399–402, June 2004
How to Cite
Wammes-van der Heijden, E. A., Tijssen, C. C., Van't Hoff, A. R. and Egberts, A. C. G. (2004), A Thromboembolic Predisposition and the Effect of Anticoagulants on Migraine. Headache: The Journal of Head and Face Pain, 44: 399–402. doi: 10.1111/j.1526-4610.2004.04090.x
- Issue published online: 7 MAY 2004
- Article first published online: 7 MAY 2004
- Accepted for publication November 10, 2003.
- migraine prophylaxis;
- thromboembolic predisposition;
Objective.—To investigate the presence of thromboembolic risk factors and the effect of low-dose acenocoumarol therapy on migraine in patients who spontaneously reported a reduction of their migraine attacks during previous therapeutic use of anticoagulants.
Background.—The positive effect of anticoagulants on migraine has been described in case reports and observational studies. It remains unclear whether this concerns only a select group of migraineurs with certain common characteristics.
Methods.—In 4 migraineurs with a self-reported reduction of attack frequency during previous use of anticoagulants (international normalization ratio [INR], 2.5:4.0), the presence of thromboembolic risk factors and the effect of low-dose acenocoumarol therapy (INR, 1.5:2.0) on migraine attacks were prospectively investigated in an open study.
Results.—All patients had one or more thromboembolic risk factors. Two patients, both with factor V Leiden heterozygosity, experienced a clear improvement of migraine during low-dose acenocoumarol therapy.
Conclusions.—Our findings support the hypothesis that migraine, as a phenotype, has different underlying mechanisms, amongst which a thromboembolic tendency. In this group of patients, oral anticoagulants may be a suitable form of migraine prophylaxis, but this needs further clinical investigation.