Kampo extract goshuyuto for prevention of paroxysmal atrial fibrillation associated with migraine attack

<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Case</jats:title><jats:p>Not only non‐steroidal anti‐inflammatory drugs (NSAIDs) but also triptans, called a ‘magic bullet’ against migraine attacks, increase the incidence of atrial fibrillation (AF). Additionally, the migraine attack itself may induce AF. A 66‐year‐old man visited hospital, complaining of palpitation after taking NSAIDs containing acetaminophen, ethenzamide and caffeine for a migraine attack. When pilsicainide hydrochloride hydrate was given, the AF was restored to sinus rhythm in 2 h.</jats:p></jats:sec><jats:sec><jats:title>Outcome</jats:title><jats:p>Goshuyuto, a kampo formula used for headache, consists of four constituent drugs: <jats:italic>Zizyphus</jats:italic> fructus, <jats:italic>Evodia</jats:italic> fructus, <jats:italic>Ginseng</jats:italic> radix and <jats:italic>Zingiber</jats:italic> rhizome; these four crude drugs may induce multiple interactions. After taking goshuyuto combined with sodium valproate, no further migraine occurred for 3 months and no AF was observed.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The kampo extract goshuyuto may be an option to prevent paroxysmal AF associated with migraine attack.</jats:p></jats:sec>