8.1.2 Phosphodiesterase (PDE) inhibitor-induced headacheHartmut Gobel2018-01-31T11:01:49+00:00
Description:
Headache caused by intake of a phosphodiesterase inhibitor, resolving spontaneously within 72 hours.
Diagnostic criteria:
- Any headache fulfilling criterion C
- A phosphodiesterase (PDE) inhibitor has been taken
- Evidence of causation demonstrated by all of the following:
- headache has developed within 5 hours of intake of the PDE inhibitor
- headache has resolved within 72 hours of onset
- headache has at least one of the following four characteristics:
- a)bilateral
- b)mild to moderate intensity<
- c)pulsating quality
- d)aggravated by physical activity
- Not better accounted for by another ICHD-3 diagnosis.
Comment:
Phosphodiesterases (PDEs) are enzymes that break down cGMP and cAMP. The PDE-5 inhibitors, sildenafil and dipyridamole, increase levels of cGMP and/or cAMP. The resultant headache is usually tension-type-like, but in people with 1. Migraine (who should be warned of this side effect) it has the characteristics of 1.1 Migraine without aura.