ALTERNATIVES IN DRUG-TREATMENT OF CHRONIC PAROXYSMAL HEMICRANIA

Indomethacin is the drug of first choice in chronic paroxysmal hemicra nia with clear relief of pain as a diagnostic criterion. In a few case s, indomethacin is not tolerated because of side effects. Therefore, t he efficacy of carbamazepine, verapamil, sumatriptan, acetylsalicylic acid, and oxygen as drugs in the prophylactic or acute treatment of ch ronic paroxysmal hemicrania was studied in a prospective open trial wi th 10 patients suffering from chronic paroxysmal hemicrania. The trial results, in accordance with a review of the literature, suggest that acetylsalicylic acid (and probably naproxen and diclofenac) and verapa mil are the most effective drugs of second choice in chronic paroxysma l hemicrania. The efficacy of sumatriptan in this condition needs stil l to be clarified, although there is evidence for partial efficacy. Ca rbamazepine and oxygen did not show any significant influence on chron ic paroxysmal hemicrania.