Pizotifen, better known by its brand name, Sandomigran®, is a medication used to help prevent vascular headaches such as cluster or migraine headaches. It is used as a preventative measure, but is not considered sufficient as a treatment once pain has already begun. This medication is generally thought to be effective, but is usually prescribed as a last resort because it is known to cause several side effects. Pizotifen is widely used throughout Canada and Europe.
Certain types of headaches, such as migraines, are associated with the widening of blood vessels in the brain. At the start of a migraine attack, it is thought that serotonin is released, causing blood vessels to narrow. Other chemicals are also released that can cause the blood vessels to expand. Pizotifen works by blocking serotonin receptors within the brain, which in turn is said to stop blood vessels from rapidly widening and narrowing. In addition, it is thought to block histamine receptors, which may also cause a widening of blood vessels, as well as inflammation.
Pizotifen is chemically similar to many antidepressants in structure and action, and it is thought that it may be similar in effect. In animal testing, this drug exhibited a mild sedative quality, which was thought to be beneficial in treating mild to moderate depression and anxiety. Other animal testing has shown that this medication may be effective in treating an overdose of the drug known as Ecstasy, or 3,4-Methylenedioxymethamphetamine (MDMA).
In many cases, a doctor may initially prescribe a low dose of this medication, then gradually increase the dosage until it becomes effective. To help lessen side effects, many doctors will try to prescribe the lowest dose that will provide the best results. Over time, a doctor may dispense lower doses to see if taking this drug is still necessary.
The most common side effects associated with taking pizotifen are drowsiness, increased appetite, and weight gain. These are thought to be temporary, and may subside over time. There are also several other side effects that are considered less common. These may include confusion or nervousness, weakness, dry mouth, and fluid retention.
This drug may also interact negatively with other medications. Antidepressants, antihistamines, and sleeping pills may cause further drowsiness. Alcohol, as well as heart and diabetes medications, may interact with this medication as well. In addition, natural remedies such as St. John's wort may lower the effectiveness of pizotifen.