Resolution of new daily persistent headache by a tumor necrosis factor alpha antagonist, Venlafaxine. (May 2019)

• Record Type: Journal Article
• Authors: Tariq, Zeshan; Board, Nathan; Eftimiades, Alex; Ibrahim, Ronnie
• Is Part Of: SAGE open medical case reports. Volume 7(2019)
• Publication Date: 2019-05
• Subjects: New daily persistent headache -- headache -- NDPH -- TNF-alpha -- tumor necrosis factor alpha -- Venlafaxine -- 5HT-2a -- serotonin; Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1177/2050313X19847804
• Languages: English
• ISSNs: 2050-313X

Abstract

New daily persistent headache is a continuous, unremitting headache, notorious for its unresponsiveness to aggressive medical interventions. The underlying pathophysiology of new daily persistent headache is poorly understood resulting in unending, chronic pain. However, a prior study identified elevated tumor necrosis factor alpha within the cerebral spinal fluid of new daily persistent headache patients. Herein, we report on a patient who suffered with headache for 6 years failing to respond to over 20 different medical treatments, but found drastic improvement and eventual resolution with Venlafaxine. This drug binds to the 5-HT2A receptor inhibiting tumor necrosis factor alpha signaling. Therefore, we hypothesize a chronic inflammatory mechanism driving new daily persistent headache pathology.