Here’s the roundup of migraine treatments. Other news posts I’m working on are about presentations at the International Headache Society’s conference (including cluster headache news), depression and chronic pain.
Migraine Patients Who Take Triptans Report Greater Satisfaction Than Patients Taking Barbiturates or Opioids
Survey: Migraine Patients Taking Potentially Addictive Barbiturate or Opioid
Medications Not Approved By FDA as Migraine Treatments
The survey found that patients taking triptans are significantly more likely than those taking barbiturates or opioids to report that their medication works well at relieving migraine symptoms, with sixty percent of triptan patients reporting that it describes their medication “extremely” or “very” well to say it relieves their migraines symptoms completely compared with 42 percent of patients taking barbiturates and opioids.
Patients taking opioids and barbiturates for their migraines also reported a lower quality of life than patients taking triptans, according to the survey. Patients taking these drugs were twice as likely as patients on triptans to say that migraines “always” limited their ability to exercise or play sports (35% vs. 14%), engage in sexual activity (33% vs. 17%), drive a car (28% vs. 14%), spend time with family and friends (28% vs. 8%) or simply get out of the house (33% vs. 15%).
Though many patients are prescribed barbiturates and opioids for their migraines, the majority indicated that they prefer their migraine medication to be FDA approved for the disease, not addictive and have few side effects. Seven out of ten patients (72%) surveyed said it’s “extremely” or “very” important that their prescription medications not be addictive, and eight out of ten patients (79%) said it’s “extremely”
or “very” important that their prescription medication have only minor side effects. Sixty-five percent said it’s important that their migraine medication be approved by the FDA to treat the disease.
Frova for Menstrual Migraine
Endo’s Menstrual Migraine Treatment Better Than Placebo in Study
Endo Pharmaceuticals said that its Frova 2.5mg tablets reduced the frequency and severity of difficult-to-treat menstrual migraine in women when used as a six-day preventative regimen.
Predicting Botox ‘s Effectiveness
Cutaneous Allodynia Predicts Response to Botulinum Toxin Type A in Migraine Patients
Botulinum toxin type A has been reported to be effective in preventing migraine attacks in some patients but not in others.
[R]esearchers found that patients with cutaneous allodynia had experienced significant reductions (P <.01) in migraine frequency and number of headache days in response to botulinum toxin type A, whereas patients without cutaneous allodynia had no such improvement in symptoms.
[I]nvestigators concluded that cutaneous allodynia could be used to predict which migraine patients are likely to respond to prophylactic therapy with botulinum toxin.
DHE Relieves Skin Sensitivity (Allodynia)
Migraine With Skin Sensitivity Eased By Older Drug
Dihydroergotamine or DHE, an established drug for migraine, works well even when the attack is accompanied by super-sensitivity to touch or heat and cold, according to researchers.
Many migraine sufferers get relief from the newer drugs known as triptans, but these are less effective when people also have heightened skin sensitivity. This condition, called cutaneous allodynia, makes even a light touch to the face or neck feel painful.
“Unlike triptans, DHE works in the presence of allodynia, any time in the migraine attack,” lead investigator Dr. Stephen D. Silberstein told Reuters Health.
Migraine Preventives
Migraines: Symptoms Disappear With The Right Prevention
According to Greek researchers, migraine sufferers can eliminate symptoms altogether if they take higher doses of anti-migraine medicine for a longer period of time than is now customary. Another team of researchers has found that certain psychopharmaceuticals could serve as a new therapy option for persistent chronic headaches.
“In treating migraines, optimizing the effect of already available agents is at least as important a task as developing new substances.”
I’m a little wary of this article, but wanted you to know about it. Take it with a grain of salt.
I found this very interesting and a bit relieving.(I am not crazy, other people have a painful face and hair!)
I recieve botox treatments every 10-12 weeks and take ergotamines (migranal and DHE inj.). I also experience allodynia with probably 80% of my migraines. I have had a tremendous decrease in my migraines since starting the botox tx. Also ergotamines work for me approx.75% of the time (whereas triptans don’t work at all anymore.) I hope these studies help other migraineurs be treated faster with the appropriate drugs. It is wonderful to find a symptom that can point in the right direction of treatment. I am sure we all have been through the months and years of unsuccessful treatments!
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It’s also a really cool finding for us health geeks!
Kerrie
OK–since I was there, I guess I should comment, eh? BTW, Stockholm is fabulous, and I can recommend it whole-heartedly and unreservedly.
First, cutaneous allodynia, the skull and scalp, and Botox. This was far and away the coolest lecture, although it was also given at the American Headache Society Meeting. Dr. Rami Burstein, who is a basic science researcher at Harvard, has done some ground-breaking research. It has been conventional wisdom that there are no pain receptors within bone; the only pain receptors are on the periosteum–the lining on the bone. Dr. Burstein took it into his head to wonder if this were actually true of the skull, and set out to trace the pain pathways in rats. He showed amazing slides of fluorescent lime green nerve fibers shooting right through holes in the bone of the skull (so, yes, your skull can hurt), and terminating at the hair follicle.
So–when people say they have headaches that feel as if their hair hurts, it can be literally true. These nerve fibers were most dense at the sutures in the skull, where the bony plates of the skull come together. And now we know why craniosacral therapy works!
Dr. Burstein has also determined that there are three major types of headache pain–explosive pain (like you feel as if your brain is too big and will explode out of your head), implosive pain (as if your head will cave in the pressure is so great), or orbital/eye pain (your eye hurts, or it hurts behind your eye, or it hurts to move your eye). Unfortunately, you are permitted to have more than one of these in a given headache. He has found that it is the implosive type of pain that is most likely to respond to Botox.
Now–as for the neuroleptics. Most of the atypical antipsychotics have been in use for headache prevention for some time, so not sure why you are requiring a grain of salt. It’s always good to back up clinical practices with studies, though.
Or was the grain of salt comment regarding taking higher doses of common preventatives for longer periods of time? I do see this error commonly in my practice as well. Drug-switching after a week is not uncommon. Nothing will work in this time-frame, and primary care needs to be more aware of this, and not give in to frantic and desperate patients and parents.
There was a lot more, and as Kerrie posts on it, I’ll comment on it.
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That is so cool! I’m looking forward to what you have to say about other news from the convention.
Kerrie