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Main Category: Headache / Migraine
Article Date: 23 Apr 2012 - 21:00 PDT
Current ratings for:Migraines - Many Treatments Work, But Few Use Them
Although several preventive migraine treatments are very effective for many patients, few sufferers use them, according to new American Academy of Neurology guidelines. The guidelines have been published in the journal Neurology and will be presented tomorrow at the American Academy of Neurology's 64th Annual meeting in New Orleans.
Author Stephen D. Silberstein, MD, FACP, FAHS, of Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow of the American Academy of Neurology, said:
"Studies show that migraine is underrecognized and undertreated. About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them."
Preventive treatments are generally administered daily to prevent migraine attacks from ever occurring, or to lessen their severity and length of duration if they do.
Silberstein said:
"Some studies show that migraine attacks can be reduced by more than half with preventive treatments."
All evidence related to migraine prevention was reviewed before the guidelines were made.
The following prescription medications were found to be effective in preventing migraine attacks, or at least reducing their severity and/or duration: divalproex sodium (a seizure medication)sodium valproate (a seizure medication) topiramate (a seizure medication)metoprolol (beta blocker)propranolol (beta blocker)timolol (beta blocker)The guidelines say that doctors should offer these medications for the prevention or reduction in frequency or severity of migraine attacks.
The guidelines say that Lamotrigine, a seizure medication, does not prevent migraine.
According to the guideline, herbal preparation Petasites (butterbur) can effectively prevent migraine attacks.
The following were also found to be effective: NSAIDs (nonsteroidal anti-inflammatory drugs)
FenoprofenIbuprofenKetoprofenNaproxen and naproxen sodiumSubcutaneous histamine
Complementary treatments
MagnesiumMIG-99 (feverfew) RiboflavinEven though patients do not require a prescription for these OTC medications and complementary therapies, Dr. Silberstein said that patients should still visit their doctor for their scheduled follow-up appointments.
Silberstein said:
"Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication. In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side effects or interact with other medications, which should be monitored."
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Visit our headache / migraine section for the latest news on this subject. "Update: Pharmacologic Treatment for Episodic Migraine Prevention in Adults"
S.D. Silberstein, S. Holland, F. Freitag, et al.
Neurology 2012;78;1337. DOI 10.1212/WNL.0b013e3182535d20
"Update: NSAIDs and Other Complementary Treatments for Episodic Migraine Prevention in Adults"
S.D. Silberstein, S. Holland, F. Freitag, et al.
Neurology 2012;78;1346. DOI 10.1212/WNL.0b013e3182535d0c
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posted by Helen S on 12 May 2012 at 4:04 am My son developed a migraine in March last year and it has never gone away, from the minute he wakes up till he finally falls asleep that pain is with him always. it is continuous. They also had a possibly incidental finding of a huge arachnoid cyst on his brain He has been hospitalised twice and he only turned 16 this christmas. He tried topirimate for 6 months last year which did no good, he is about to complete 6 months of the highest dosage he can take of propranalol which has also made no difference, he also had no side effects we could detect, he is also supposed to take ibuprofen and zomig twice a week, but as this also had no effect he has stopped. He has also tried acupuncture and reflexology which have also not helped. I understand the health professionals have got to try b/c for some people it will work and it must be worth it to help that one. what i have found interesting is all the alternatives you have found to help some of you, magnesium, feverfew etc. This has given me some avenues to pursue, thanx.
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posted by Kelly on 3 May 2012 at 9:11 pm I must agree with "stupidmax". Haven't heard that analogy, but can relate. I tried topamax and stopped taking the drug b/c I immediately became extremely tired and the drug put me in this thick fog. There is no way any type of life functioning was going to take place on that drug. And taking it for the recommended 2 weeks for full effect was out of the question. Magnesium supplements seem to be effective for some sufferers-I think I will try this.
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posted by Laura Larrett on 25 Apr 2012 at 6:06 pm I am 62 and 12 years ago, I started tp get daily migeraines and even imitrex did not work. A neurostimulator was put in and it worked well for 3 months then the leads fell off the nerve. They unhooked the wires but left the wires in and they poked thru my skin and I got a psuedomonas infection. We waited another year and they put another Medronic device but it never worked. I lost my insurance and am afraid of getting it out. This was 5 years ago. The only thing that worked at all was Feverfew 180 mg, B2 (4oo mg, magnesium 400 mg. Co Q 10 200 mg, and Butterburr,150 mg. I was always told they would go away at menopause but instead some women get more.
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posted by cathy morgan on 24 Apr 2012 at 7:56 am most of the drugs listed i tried due to severe migraine starting in my teens...propranolol (beta blocker) and topamax cause weight gain of up to 30 lbs !!! and do not work !!!!!!also i developed colitis and the colonoscopy doctor told me ibuprofen is known to cause colitis!!!!i did not know that! PEOPLE DO NOT KEEP TAKING THEM B/C THEY DO NOT WORK...where did this doctor get his info?? and does he "lecture" for a pharmacutical company??
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posted by TrannyGirl on 24 Apr 2012 at 12:30 am I've watched my room mate suffer with intense migraines for the last 3 years, on an almost daily basis. I've taken him to the doctor numerous times to be treated for pain so overwhelming that he was puking. I've taken him to the emergency room from the terrible reactions to almost every one of the medications on the list in this article.
He was NOT able to continue to use any of the prescription drugs due to life threatening reactions, hallucinations, nightmares or the complete failure of the drug to have any effect at all. The only legal item on the list that actually worked was Feverfew.
Today, he started on a regimen of enzymes and Feverfew that seems to be working the best of anything he's tried in 3 years.
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posted by H Nasr on 23 Apr 2012 at 11:32 pm Great article! Knowing which prophylactic medication to use is usually a trial and error process. They certainly can take a few weeks to work, so it is important to try a particular medication for several weeks before giving up.
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posted by Chuck on 23 Apr 2012 at 11:24 pm No wonder they no being used. Take "topiramate" - more people know it by it's brand name: Topamax. There's a good reason that most people who have tried it know it by its nickname: Stupidmax. How many of the other work by putting people so out of it that they can barely function? Come on people, the WHOLE story.
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posted by Sam on 23 Apr 2012 at 10:22 pm I've had migraines my entire life. The single most helpful thing that I ever did, was to ask a good Chiropractor about helping me with them. With his guidance and the exercises he taught, I feel like I can conquer migraines. The severity and frequency of my migraines have significantly decreased. I only resort to Imitrex when I must.
I have tried topiramate. I felt that I would rather endure the worst migraines, than suffer the side effects from that drug!
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posted by john on 23 Apr 2012 at 10:05 pm I have migrains once to twice per month. The kind where you shut down turn off the lights and try to be still. I take 2-3 advil and hope for the best. I have noticed that my migrains coorelate with high bp reading. I have home monitor and check when I have them vs. not. In all cases I have elevated bp. 130/95 plus.
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posted by md on 23 Apr 2012 at 9:49 pm I an not one of those pp. U can call a health nut...yet, when my daughter was diagnosed with migraine headaches & the Dr.s were willing to have her medicated for life I tried a healthy approach which was suggested to me. My daughter has not eaten anything with wheat or sugar in it & let me tell u I learnt a whole new cooking & baking regime...everything is possible & we have access to so many sub products... (spelt flour, exilotol...) My child is a healed person... It's been two years now and I strongly encourage this approach!
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posted by Paul Dolph on 23 Apr 2012 at 9:46 pm I was taking zomig two or three at a time to stop my daily migarines. About ten years ago I started taking 400mg of magnesium a day and I have not had a headache since.
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