DOI: http://dx.doi.org/10.18203/2349-3933.ijam20211051

Lisinopril as a prophylactic agent for migraine: a randomised double blind placebo controlled cross over prospective study in Kashmir

Irfan Yousuf Wani, Sheikh Saleem, Iqra Mehraj

Abstract


Background: Migraine is one of the commonest neurological disorder seen by neurologists. Many different medications are available to be used as prophylactic agent. We conducted this study to determine the efficacy of Lisinopril as a prophylactic drug for migraine in our region.

Methods: Our study is a randomised double blind, placebo controlled, cross over, prospective study. 60 patients were included in this study. Treatment period of 12 weeks with one 10 mg lisinopril tablet once daily for one week then two 10 mg lisinopril tablets once daily for 11 weeks, followed by a two week wash out period. Second treatment period of one placebo tablet once daily for one week and then two placebo tablets for 11 weeks. Thirty participants followed this schedule, and 30 received placebo followed by lisinopril. Primary end points were number of hours with headache, number of days with headache, number of days with migraine.

Results: Statistical analysis of data from 41 patients that completed this study revealed that hours with headache, days with headache, days with migraine, and headache severity index were significantly reduced by 16%, 16% , 23% and 17% , respectively, with lisinopril as compared to placebo.

Conclusions: This study favours lisinopril as an effective prophylactic drug for migraine. The adverse effects of lisinopril, though of significant frequency, have been mild to moderate in severity but were well tolerated by even normotensive subjects.


Keywords


Lisinopril, Migraine, Kashmir

Full Text:

PDF

References


World Health Organization. Atlas of Headache Disorders and Resources in the World 2011. World Health Organization; Geneva, Switzerland. 2011. https://www.who.int/mental_health/management/atlas_headache_disorders/en/. Last accessed on 20th January 2021,

Wang SJ. Epidemiology of migraine and other types of headache in Asia. Curr Neurol Neurosci Rep. 2003;3(2):104-8.

Sayed-Tabatabaei FA, Oostra BA, Isaacs A, van Duijn CM, Witteman JC. ACE polymorphisms. Circ Res. 2006;98(9):1123-33.

Skidgel RA, Erdos EG. The broad substrate specificity of human angiotensin converting enzyme. Clin Exp Hypertens A. 1987;9:243­59.

Paterna S, Di Pasquale P, D'Angelo A, Seidita G, Tuttolomondo A, Cardinale A, et al. Angiotensin converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura. European Neurology. 2000;43:133-6.

Tiret L, Bonnardeaux A, Poirier O. Synergistic effects of angiotensin-converting enzyme and angiotensin-II type 1 receptor gene polymorphisms on risk of myocardial infarction. The Lancet. 1994;344(8927):910-3.

Naresh VVS, Reddy ALK, Sivaramakrishna G, Sharma PVGK, Vardhan RV, Kumar VS. Angiotensin converting enzyme gene polymorphism in type II diabetics with nephropathy. Indian Journal of Nephrology. 2009;19(4):145-8.

Morise T, Takeuchi Y, Takeda R. Angiotensin-converting enzyme polymorphism and essential hypertension. The Lancet. 1994;343(8889):125-130.

Zhou YF, Yan H, Hou XP, Miao JL, Zhang J, Yin QX et al. Association study of angiotensin-converting enzyme gene polymorphism with elderly diabetic hypertension and lipids levels. Lipids Health Dis. 2013;12:187.

Baghai TC, Schule C, Zwanzger P. Possible influence of the insertion/deletion polymorphism in the angiotensin I‐converting enzyme gene on therapeutic outcome in affective disorders. Mol Psychiatry. 2001;6:258-9.

Schrader H, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with angiotensin converting enzyme inhibitor (lisinopril): randomised, placebo controlled, crossover study. BMJ. 2001;322:19-22.

Schuh-Hofer S, Flach U, Meisel A, Israel H, Reuter U, Arnold G. Efficacy of lisinopril in migraine prophylaxis – an open label study. European Journal of Neurology. 2007;14:701-703.

Bender WI. ACE inhibitors for prophylaxis of migraine headaches. Headache. 1995;35:470-471.

Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker. JAMA. 2003;289:65-9.

International Headache Society Committee on Clinical Trials in Migraine. Guidelines for controlled trials of drugs in migraine. Cephalalgia. 1991;11(1):1­12.