Reactions 1172 - 6 Oct 2007

★Citalopram

First report of trigger of migraine with aura: casereport

A 19-year-old woman experienced a trigger of migraine withaura during treatment with citalopram.

The woman was hospitalised with headache and associatedphotophobia, phonophobia, nausea and vomiting, which didnot respond to paracetamol [acetaminophen] and caffeine.She received diazepam, NSAIDs and bedrest and hersymptoms were relieved within 3 days. During the following4 days, she received citalopram 10 mg/day for anxiety. Onehour after ingestion of each citalopram dose, she experiencedgradual setting of left homonym hemianopsia, which lastedapproximately 40 minutes, followed by bilateraltemporofrontal throbbing headache. She also experiencedassociated phonophobia, photophobia, nausea, vomiting anddizziness. She reported that these stereotypical attacks did notrespond to treatment with paracetamol and caffeine.

Citalopram was discontinued and the woman’s attacksstopped. Six days later, she was admitted with a throbbingheadache associated with nausea, photophobia andphonophobia. She was diagnosed as having migraine with andwithout aura.

Author comment: "[W]e suggested that the attack-precipitating character of SSRI medications (which increasesthe synaptic serotonin amount) in the first days of treatmentcould be related to individual differences in expressions and/or sensitivities of 5-HT receptor subgroups in the brain."Alemdar M, et al. Migraine with aura triggered by citalopram.Neuropsychobiology 55: 121-122, No. 2, 2007 - Turkey 801091579

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of migraine or auraassociated with citalopram. The WHO Adverse Drug Reactionsdatabase contained 60 reports of migraine associated withcitalopram and one report of aura associated with citalopram.

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Reactions 6 Oct 2007 No. 11720114-9954/10/1172-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved