Aminophylline in pain and migraine

Although the pathogenesis of migraine is not fully understood, accumulating evidence indicates migraine may be driven by impaired brain energy metabolism in the context of pathologically high levels of adenosine. Considerable evidence indicates that aminophylline, an adenosine receptor antagonist, c...

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Bibliographic Details
Published in:	Pain management Vol. 13; no. 12; p. 723
Main Authors:	Phillips, Barrie L, Phillips, Matthew Cl
Format:	Journal Article
Language:	English
Published:	England 01-12-2023
Subjects:	Aminophylline - therapeutic use Drug-Related Side Effects and Adverse Reactions - drug therapy Headache Humans Migraine Disorders - drug therapy Pain - drug therapy adenosine pain metabolism migraine theophylline aminophylline
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Summary:	Although the pathogenesis of migraine is not fully understood, accumulating evidence indicates migraine may be driven by impaired brain energy metabolism in the context of pathologically high levels of adenosine. Considerable evidence indicates that aminophylline, an adenosine receptor antagonist, can provide strong therapeutic relief in pain, particularly post-dural headache. Moreover, direct observations from a previously published observational case series have demonstrated a strong therapeutic impact of low-dose aminophylline in patients with severe, unremitting migraine attacks. Although higher doses of aminophylline are associated with an unfavourable adverse effect profile, low doses of aminophylline are associated with minimal adverse effects. Despite this promise, double-blinded randomized trials will be needed to determine the true therapeutic efficacy of low-dose aminophylline in migraine.
ISSN:	1758-1877
DOI:	10.2217/pmt-2023-0076