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Tired of searching the Internet for answers? It’ s time to learn from those in the know. In every issue of Head Wise, our experts respond to reader-submitted questions about migraine and headache disorders.
Bad Medicine
In the last seven days, I have been taking the prescription medications hydroxyurea and allopurinol. This is a regimen designed to reduce a very high blood platelet count. I take one pill in the morning and the other in the evening.
Unfortunately, I have been experiencing headaches after taking each pill. I realize I am in the early days of ingesting strong medicine and can experience a wide variety of side effects. Nevertheless, there is nothing in the literature indicating that headache is a side effect of either medication. I have been prone to headaches most of my life, but these new headaches are worse than the ones I usually get. I am aspirin averse because of an ulcer. Tylenol does not give me much relief. I am 67 years old and in generally good health aside from the blood issue. I have tried migraine medications but am reasonably sure these are not migraine headaches.
I am reviewing this matter with my doctor, but any advice or information you can share would be greatly appreciated. – Marcia G. It sounds like you have a diagnosis of essential thrombocythemia, a disorder in which the platelet count is quite high. In patients with this disorder, the platelets can back up in blood vessels, which might lead to headache. In addition, rarely patients can have a stroke or blood clots in the veins of the head, known as dural venous thrombosis. If these are new-onset headaches, you might consider getting an MRI( magnetic resonance image) and an MRV( magnetic resonance venograph) of the brain if your physician thinks it is appropriate. Hydroxyurea therapy has been reported to cause headache. It is unknown how this happens, but it is possible the hydroxyurea destroys platelets containing chemicals, such as serotonin, that can trigger headaches. Typically, we would recommend aspirin or NSAIDs to treat such headaches, but if you have had an ulcer, it
8 HEAD WISE | Volume 1, Issue 3 • 2011