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Ketamine‐Magnesium for Refractory Chronic Cluster Headache: A Case Series.

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Title: Ketamine‐Magnesium for Refractory Chronic Cluster Headache: A Case Series.
Authors: Moisset, Xavier, Giraud, Pierric, Meunier, Estelle, Condé, Sakahlé, Périé, Maud, Picard, Pascale, Pereira, Bruno, Ciampi de Andrade, Daniel, Clavelou, Pierre, Dallel, Radhouane
Source: Headache: The Journal of Head & Face Pain. Nov2020, Vol. 60 Issue 10, p2537-2543. 7p.
Subjects: Combination drug therapy, Cluster headache, Confidence intervals, Intravenous therapy, Ketamine, Magnesium sulfate, Case studies, Multidrug resistance, Treatment effectiveness, Descriptive statistics, Pharmacodynamics
Geographic Terms: France
Abstract: Objectives: To evaluate the safety and efficacy of ketamine‐magnesium combination to reduce attacks in a series of patients with refractory chronic cluster headache (rCCH). Background: Refractory chronic cluster headache (CCH) is a rare but highly debilitating condition that needs new treatment options. A previous publication reported that a single infusion of ketamine‐magnesium combination was effective in 2 patients with rCCH. Methods: The treatment was proposed to consecutive patients with rCCH seen in 2 French hospitals between November 2015 and February 2020 and who were resistant to at least 3 preventive treatments. They received a single ketamine infusion (0.5 mg/kg over 2 hours) combined with magnesium sulfate (3000 mg). The main outcome was a comparison of the number of daily attacks 2 weeks prior to the ketamine‐magnesium infusion and 1 week after (on days 7 and 8). The second outcome was the percentage of responders (patients with ≥50% reduction in the frequency of daily attacks). Safety was assessed by the recording of adverse events during infusion. Descriptive statistics are presented as mean ± standard deviation. Results: Seventeen patients (14 men), with an age of 35.2 ± 8.1 years, were included. They presented with CCH for 6.6 ± 4.3 years. The number of daily attacks decreased from 4.3 ± 2.4 before treatment to 1.3 ± 1.0 after treatment (difference: −3.1 (95% CI: −4.5 to −1.6), P <.001). Seventy six percent (13/17) were responders. Transient and mild sedation was reported by 7/17 patients (41.2%). Conclusions: The ketamine‐magnesium combination seems an effective and well‐tolerated therapy for rCCH. Placebo‐controlled studies should be conducted to further confirm these findings. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Ketamine‐Magnesium for Refractory Chronic Cluster Headache: A Case Series.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Moisset%2C+Xavier%22&quot;&gt;Moisset, Xavier&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Giraud%2C+Pierric%22&quot;&gt;Giraud, Pierric&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Meunier%2C+Estelle%22&quot;&gt;Meunier, Estelle&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cond&#233;%2C+Sakahl&#233;%22&quot;&gt;Cond&#233;, Sakahl&#233;&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22P&#233;ri&#233;%2C+Maud%22&quot;&gt;P&#233;ri&#233;, Maud&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Picard%2C+Pascale%22&quot;&gt;Picard, Pascale&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pereira%2C+Bruno%22&quot;&gt;Pereira, Bruno&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ciampi+de+Andrade%2C+Daniel%22&quot;&gt;Ciampi de Andrade, Daniel&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clavelou%2C+Pierre%22&quot;&gt;Clavelou, Pierre&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dallel%2C+Radhouane%22&quot;&gt;Dallel, Radhouane&lt;/searchLink&gt;
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  Data: Objectives: To evaluate the safety and efficacy of ketamine‐magnesium combination to reduce attacks in a series of patients with refractory chronic cluster headache (rCCH). Background: Refractory chronic cluster headache (CCH) is a rare but highly debilitating condition that needs new treatment options. A previous publication reported that a single infusion of ketamine‐magnesium combination was effective in 2 patients with rCCH. Methods: The treatment was proposed to consecutive patients with rCCH seen in 2 French hospitals between November 2015 and February 2020 and who were resistant to at least 3 preventive treatments. They received a single ketamine infusion (0.5 mg/kg over 2 hours) combined with magnesium sulfate (3000 mg). The main outcome was a comparison of the number of daily attacks 2 weeks prior to the ketamine‐magnesium infusion and 1 week after (on days 7 and 8). The second outcome was the percentage of responders (patients with ≥50% reduction in the frequency of daily attacks). Safety was assessed by the recording of adverse events during infusion. Descriptive statistics are presented as mean &#177; standard deviation. Results: Seventeen patients (14 men), with an age of 35.2 &#177; 8.1 years, were included. They presented with CCH for 6.6 &#177; 4.3 years. The number of daily attacks decreased from 4.3 &#177; 2.4 before treatment to 1.3 &#177; 1.0 after treatment (difference: −3.1 (95% CI: −4.5 to −1.6), P &lt;.001). Seventy six percent (13/17) were responders. Transient and mild sedation was reported by 7/17 patients (41.2%). Conclusions: The ketamine‐magnesium combination seems an effective and well‐tolerated therapy for rCCH. Placebo‐controlled studies should be conducted to further confirm these findings. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Headache: The Journal of Head &amp; Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1111/head.14005
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 7
        StartPage: 2537
    Subjects:
      – SubjectFull: Combination drug therapy
        Type: general
      – SubjectFull: Cluster headache
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Intravenous therapy
        Type: general
      – SubjectFull: Ketamine
        Type: general
      – SubjectFull: Magnesium sulfate
        Type: general
      – SubjectFull: Case studies
        Type: general
      – SubjectFull: Multidrug resistance
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Pharmacodynamics
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      – SubjectFull: France
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      – TitleFull: Ketamine‐Magnesium for Refractory Chronic Cluster Headache: A Case Series.
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            – D: 01
              M: 11
              Text: Nov2020
              Type: published
              Y: 2020
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