Introduction The phosphodiesterase-3-inhibitor
cilostazol induces
migraine-like attacks in patients with
migraine without aura, and may be used as a pharmacological trigger in human experimental models of
migraine. However, the reproducibility of
cilostazol-induced
migraine-like attacks has never been investigated. Methods We performed a post-hoc analysis of clinical data from two brain-imaging studies including subjects who had received
cilostazol 200 mg orally. Only subjects who developed
migraine-like attacks on study day 1 were included on study day 2. After
cilostazol ingestion, subjects and the investigator recorded
headache intensity and characteristics once every hour on a purpose-developed questionnaire. Primary end-points included incidence and time to onset of
migraine-like attacks between two separate study days. Results Thirty-four subjects completed both experimental days and were included in this study. Thirty-four out of 34 subjects (100%) developed
migraine-like attacks after
cilostazol ingestion on both study days 1 and 2. Time to onset of
migraine was five hours (range 1-8 hours) on study day 1 and four hours (range 1-8 hours) on study day 2, p = 0.16. We found no difference in median peak
headache score, median time to peak
headache score, or median time to intake of rescue medication between study days 1 and 2. Conclusion A second-time administration of
cilostazol reproduces
migraine-like attacks in all subjects who report an attack after their first
cilostazol induction. There was no difference in time to
migraine onset between separate inductions. Experimental
migraine provocation using
cilostazol is a highly efficient and useful approach for studying the ictal phase of
migraine without aura.