Migraine and Cluster Headache Treatment With Calcium Antagonists Supports a Vascular Pathogenesis

Abstract

SYNOPSIS Clinical research during the past four years in this and other laboratories has demonstrated therapeutic effectiveness of three different calcium channel blockers in the prophylaxis of migraine and cluster headaches. The drugs are nimodipine, nifedipine and verapamil. Clinical observations and cephalic hemodynamic responses correlated before and during treatment with nimodipine show extremely low incidences for development of tolerance and/or side effects plus normal glucose tolerance and calcium dependent insulin secretion before and during nimodipine therapy. The results confirm potent and highly selective calcium entry blockade of cephalic smooth muscle receptors by nimodipine. Nifedipine and verapamil showed less therapeutic effectiveness in controlling headaches, higher incidence for development of tolerance and side‐effects with less consistent cephalic hemodynamic changes. Taken together these observations during treatment of migraine and cluster with calcium antagonist support Wolff's theory of vascular head pain.