Biomedical subjects

C Hedman

Publications and source records attributed to C Hedman.

28 records · Page 2Linked to original sources

PubMed1987

Classic migraine: effective prophylaxis with metoprolol.

Metoprolol slow-release tablets (Durules), 200 mg, given once daily in the morning were compared with placebo in the prophylaxis of classic migraine. The trial comprised eight Scandinavian neurologic centres and was designed as a double-blind cross-over study with 4 weeks' run-in, four weeks washout, and 8 weeks of either treatment. Seventy-seven patients with two to eight migraine attacks per month were entered in the trial, and 73 completed it. A total of 1119 attacks with aura symptoms and 374 without were recorded. Metoprolol was significantly better than placebo with regard to the total frequency of attacks (1.8 versus 2.5 attacks/4 weeks), mean duration of attacks (6.0 versus 8.0 h/attack), mean global rating, and consumption of analgesics per attack. Similar differences could be shown for attacks with aura symptoms alone, except for the duration of attacks. Metoprolol is the first drug for which a prophylactic effect in classic migraine has been convincingly demonstrated.

Adolescent↗

PubMed1987

Multi-centre versus single-centre trials in migraine.

Migraine trials often have to be performed at many centres, which creates a number of methodological problems. The present paper discusses single-centre versus multi-centre designs and also comments on the design of multiple-independent trials (MIT). From a methodological standpoint, the single-centre design should virtually always be preferred. When it is impossible to recruit enough patients in a single centre within reasonable time, a multi-centre design has to be used. The major advantage of multi-centre trials, apart from recruitment, is that they may yield a more representative basis for conclusions regarding the whole population. Multiple-independent trials give an opportunity to summarize information from different sources. It has not the same methodological strength as the single- or multi-centre trial, but could be valuable, especially for evaluation of side effects.

Clinical Trials as Topic↗

PubMed1986

The difference between non-selective and beta 1-selective beta-blockers in their effect on platelet function in migraine patients.

Platelet function has been postulated as playing a role in the pathogenesis of migraine. This study aimed to investigate to what extent beta 1-selective and non-selective beta-blockers interfere with the platelet function in migraine patients. Twelve patients with classical migraine were included. After a 2-week drug-free period, the patients were randomly allocated to either beta 1-selective metoprolol (50 mg b.i.d.) or non-selective propranolol (40 mg b.i.d.) treatment for one month. After a wash-out period, the patients were changed to the corresponding beta-blocker for one month. ADP-induced platelet aggregability, platelet cAMP, ATP and ADP levels, plasma cAMP and TxB2 concentration, as well as the serum production of TxB2 were measured before and after each treatment period. After propranolol treatment, the patients showed lower ADP threshold values for producing irreversible platelet aggregation and lower platelet and plasma cAMP levels as compared to metoprolol. Neither of the beta-blockers induced any change in the plasma concentration or serum production of TxB2. In conclusion, non-selective beta-blockade (propranolol) significantly increases the platelet aggregability compared to beta 1-selective blockade (metoprolol).

Adenosine Diphosphate↗

PubMed1986

Beta-adrenoceptor blockade, platelets, and rheologic factors.

Alterations in platelet function and other hemorheologic factors have been reported to occur in patients with migraine. The prophylactic treatment of migraine with beta blockers is at present well established, and non-selective as well as beta 1-selective beta blockers exert an effect. The aim of this presentation is to summarize how beta blockers, depending on their receptor selectivity, modulate platelet function and hemorheologic factors. We conclude that non-selective beta blockade increases factors, such as platelet aggregability, and decreases fibrinolytic activity compared with beta 1-selective blockade with metoprolol. These differences do not reflect on their migraine prophylactic effect and indicate that alterations in platelet function are not a primary cause of migraine: rather, they are epiphenomena.

6-Ketoprostaglandin F1 alpha↗

PubMed1985

The influence of 2,2',4,4',5,5'-hexachlorobiphenyl on the placental blood flow in guinea pigs at a late stage of gestation.

Three groups of primaparous pregnant guinea pigs were fed once daily with a total of either 0 (control group, n = 9), 3 (n = 8), or 30 mg (n = 9) of 2,2',4,4',5,5'-hexachlorobiphenyl (HCB) starting at Day 45 of gestation to evaluate the effects of HCB on placental perfusion. The guinea pigs were separated into their groups randomly. At Day 63 of gestation the organ blood flow was determined with microsphere technique in the awake animal. The results show a statistically significant decrease in the placental blood flow and an increase in the pulmonary blood flow in the animals fed with 30 mg HCB compared to the control groups. A higher incidence of resorptions in fetuses is shown in both treatment groups compared to the control group. It is concluded that ecologically relevant doses of polychlorinated biphenyls might cause a deterioration in the placental function by reducing its blood flow.

Animals↗

PubMed1985

Metoprolol and pizotifen in the prophylactic treatment of classical and common migraine. A double-blind investigation.

The prophylactic anti-migraine effect of the serotonin antagonist pizotifen and the beta 1-selective beta-adrenoceptor antagonist metoprolol was compared in a double-blind cross-over study. The dosage of pizotifen was 0.5 mg t.i.d. and that of metoprolol 50 mg b.i.d. Thirty-five patients with classical or common migraine were included in the investigation. Five patients withdrew during the course of the study; four because of side effects (three on pizotifen, one on metoprolol) and one because of unassociated illness. The results show that there was no statistically significant difference in efficacy between metoprolol and pizotifen. The tolerance, especially regarding weight gain, was the major drawback with pizotifen, while metoprolol was generally well tolerated.

Adolescent↗

PubMed1985

Metoprolol v. clonidine in the prophylactic treatment of migraine.

In a double-blind, cross-over trial, the migraine prophylactic effect of the beta 1-adrenoceptor antagonist metoprolol was compared with that of clonidine. The dosage of metoprolol was 50 mg b.i.d. and of clonidine 50 micrograms b.i.d. Thirty-one patients were included; twenty-three completed the entire study. Six patients withdrew during clonidine treatment, one during metoprolol treatment and one during the wash-out period (placebo). Metoprolol had a significantly better migraine prophylactic effect than clonidine regarding such parameters as the attack frequency, the number of migraine days and the sum of intensity score. Compared to baseline (placebo), metoprolol decreased these parameters, while clonidine did not. Metoprolol, but not clonidine, also reduced the acute consumption of analgesics. No differences were found as regards side effects.

Adolescent↗

PubMed1984

Metoprolol and propranolol in the prophylactic treatment of classical and common migraine. A double-blind study.

In a double-blind, cross-over study the effect and tolerance of the non-selective beta-blocker propranolol in a dosage of 80 mg twice daily was compared to that of the beta 1-selective beta-blocker metoprolol 200 mg once daily in Durules (a controlled-release formulation). The attack frequency, migraine days, severity score, consumption of acute medication and subjective evaluation were the main parameters used for evaluation. Thirty-six patients with classical or common migraine were included. Thirty-three completed the investigation. It is concluded from the results that there are no differences in efficacy between metoprolol and propranolol regarding the studied parameters. Both drugs reduced the migraine symptoms compared to the run-in period and were generally well tolerated.

Adolescent↗

PubMed1984

Metoprolol and propranolol in migraine prophylaxis: a double-blind multicentre study.

In a double-blind, cross-over multicentre trial, the prophylactic antimigraine effect of the beta 1-selective beta-blocker metoprolol was evaluated and compared with that of the non-selective beta-blocker propranolol. Metoprolol was used in a dosage of 50 mg b.i.d. and propranolol in 40 mg b.i.d. 56 patients with classical or common migraine were included in the double-blind part of the investigation. 3 patients withdrew, but none because of side-effects. The data suggest that metoprolol is clinically equivalent in effectiveness to propranolol in migraine prophylaxis regarding parameters such as attack frequency, improvement in sum of severity score and subjective evaluation. Both drugs were generally well tolerated and the number of reported side-effects was similar to those reported during the run-in period (placebo).

Adolescent↗

PubMed1983

Prophylactic treatment of classical and non-classical migraine with metoprolol--a comparison with placebo.

A double-blind investigation with parallel groups was carried out in three Danish neurological clinics to evaluate the effect of metoprolol (Beloc, Betaloc, Seloken) versus placebo in migraine patients. 71 patients were included; 62 completed the study. The following parameters were used in the evaluation: frequency of headache attacks, days with migraine, severity score (days X intensity), and the consumption of pain-relieving tablets. The results of the study show that metoprolol 200 mg in Durules (a controlled release formulation) once daily is more effective regarding all evaluated parameters than placebo and that metoprolol is well tolerated.

Adolescent↗