10 Highlights from the past 3 Months (November 2014 edition)

It’s been a fascinating time for migraine research and discussion.  Here are the posts which have been most popular with you, guests to this website.  Thanks for being a part of our community!

  1. Is it Migraine or Lupus?
  2. A Migraine Mystery (You’ll never guess this one…)
  3. ZECUITY: New Migraine Treatment Coming Soon…
  4. Is Stevia giving me a Migraine Attack?
  5. Are Clinical Trials Still Being “Hidden”?
  6. Migraine Surgery – Should it be Banned?
  7. Is Your Brain “Slower” During A Migraine Attack?
  8. Stabbing Headache – Could it be MS?
  9. Standard Blood Tests for Migraine – are they on the way?
  10. Sleep Apnea and Migraine – Comments from You!
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The Battle.

The Battle

Photo courtesy of Quinn Dombrowski


Her doctor had told her that this day might come – would probably come.  But knowing is not the same as being prepared.  It’s not the same as knowing what is really coming.

As the symptoms began to show themselves, she wanted to go to the hospital.  To take some medication, have some surgery – anything that would alleviate the symptoms or cure her.  But she was tired.  And she knew that there would be no easy way out.

Why don’t diseases strike at a convenient time?  Then again, what would a convenient time be?  When I didn’t have that deadline at work?  When I wasn’t planning to go out with friends?  When I hadn’t planned that precious time with my family?

There’s no reason to think about that now.  Even if there was a “good” time, even if I could choose – but I can’t.  It’s now.  And now always seems like the worst possible time.

I’m still with it enough to call and explain that I won’t be able to make it.  No, I’m so tired.  I’ll email.

They’re trying to be understanding.  “Don’t worry about it!”  They’re right – there will be other days.  Not this day.  But other days.  If . . .

But how can they brush it off like it’s nothing?  It’s a crisis.

I need help.  Who can help?  I can’t see.  I can’t think.

Time goes by.  My body shuts down.  Everybody’s body shuts down over time, as they get old – but I’m not old.  I’m young.  I wish I had a wheelchair.  It’s so hard to walk.

There’s a sound coming from outside.  What is it?  I wish it would stop.  I have to get to bed.  Where was I going?

Pain!  Oh yes, my doctor told me there would be pain.  I wish I could take something to stop it.  Oh yes, he gave me something – it won’t stop the pain, but maybe it will be a little less.

No.  I can’t even take the medication – I’m going to throw up.  Was that the phone?  Turn it off – someone turn it off!

Pain!  So much pain!

When did I go to bed today?  I don’t remember.  I don’t care.  It’s still light.  I must make it.  I can’t, but I must.

I should have undressed.  Who cares?  Pain!  I wish I had undressed.  So uncomfortable.

My mouth is dry.  Pain!  Why can’t I stop thinking about the pain?  Think about something else.  Ok – no – regrets – where I would have been in life if I hadn’t – no – can’t think about that – PAIN – can’t think – what is happening?

Need to go to the bathroom.  No, I can wait.  I can’t get up.  Can’t even reach the light switch.  If only I could turn over.  Wish I had a glass of water.  Would I be able to drink it?

There’s that noise outside again – why now?  Did I fall asleep?  Pain!  I’m going to throw up.  I know it.

I should call the doctor.  But I can’t get to the phone.  What was I supposed to do today?  What day is it?

I must have slept.  Nightmares.  Always in every dream the PAIN.  Sometimes it’s a person, sometimes an animal, or a fire or a bullet wound . . .

It’s morning.  Less pain now.  Maybe I can get up.  I was supposed to work this afternoon.

Wait – how long has it been?  Have I been sick weeks?  Months?  Why has no one called?

No – now I remember.  It was a day and a night.  I’m getting a shower.  Just a day and a night.

How did I handle so much pain?  I didn’t know I could.

I’m showered, dressed.  I’m shaking.  Still in a cold sweat.  I need to eat something.

But I did it.  Somehow.  I can’t stand up.  But I got something to eat.  It’s a great victory.

It will take time to recover.  A few days.  Can I go to work?  Should I call in sick?

So silly.  Anyone who had lived through that would call in sick for a week.  Why wouldn’t I call in sick?  Why wouldn’t I tell all my friends – they will be amazed that I survived!  Why wouldn’t I?

Most people would enjoy complaining about an experience like this for months – chatting about it in the lunch room while their friends listen with amazement and admiration.  Why can’t I?

Because it’s just a migraine.  I thought it was a battle with dragons, I thought I survived a medieval battle against incredible odds.  I thought a sword had struck me in the head and I just barely made it through, by sheer willpower.

But they say it’s just a migraine.  Just a migraine.  One of many.  Nothing to write about or talk about.  Just another one.  Is that what it was?

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Unique Migraine Nasal Spray: We’re still waiting

Back in 2008 we talked about some unique nasal sprays that were being tested for migraine treatment.  One of these was AZ-001, a nasal spray using the drug prochlorperazine.

Nasal Spray: Still Waiting.

Photo courtesy of robin_24

I’m not sure if that specific version is being actively developed by Alexza Pharmaceuticals or not, but the concept is still being researched.  Dr. Venkata Yellepeddi from Roseman University of Health Sciences has developed a nasal spray based on prochlorperazine.  Here’s what he had to say:

Prochloperazine is a dopamine receptor antagonist that is widely used as an anti-nausea medication.  Comparative clinical studies have shown that prochloperazine provides better pain relief than other anti-migraine drugs such as sumatriptan, metoclopramide, and ketorolac.  Currently, there are no marketed nasal spray formulations of prochlorperazine available for the treatment of migraine.  Prochlorperazine is only available in tablet form, which has delayed onset of action.

Prochlorperazine is already used for migraine, and is especially useful for migraine with nausea.  It’s also used for severe nausea from other causes, and in some cases as a antipsychotic.  It’s sold under brand names such as Compazine, , and Buccastem among others.

Nasal sprays are useful for a number of reasons.  For one thing, by bypassing the gut they are more useful for patients with nausea.  A more precise amount of medication will get into your system, and will be available faster.

Dr. Yellepeddi has also created a nasal spray with no preservatives, which may cause problems in some patients.  The formulation seems to be stable, but unfortunately testing is still in the early stages.  We may have to wait several more years before this one is available.

For more, read the press release from the American Association of Pharmaceutical Scientists:  First-in-class nasal spray demonstrates promise for migraine pain relief

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ZECUITY: New Migraine Treatment Coming Soon…

An old and yet brand new migraine treatment is about to be released – the ZECUITY migraine iontophoretic transdermal system (TDS)!

ZECUITY has gone through a lot of changes.  It was formerly called the Zelrix Migraine Patch, and it was developed by NuPaths.  It was approved this past January.  Earlier this year, NuPathe was acquired by Teva Pharmaceutical Industries, a company based in Israel.

Through all this change, ZECUITY has survived.  Teva has talked about launching new migraine treatment on the market this year, although the rumour now is that it may not be available to consumers until 2015.

ZECUITY is new and old because the medication is sumatriptan, an early migraine medication.  But the delivery method is all new, and for some patients that makes the difference between a drug that doesn’t work and a drug that does.

ZECUITY patch for Migraine

Dr. Deborah E. Tepper from the Cleveland Clinic describes it this way:

The sumatriptan patch consists of a single-use patch that comes in a foil packet.  After tabs are pulled to expose a small well of sumatriptan and another well of salt solution, these areas are each rubbed to release the two compounds.  The patch is placed on the upper arm or thigh, in an area where there are no tattoos or skin irritation.  A tiny battery embedded in the patch is then turned on by pushing a button.  A red light comes on, indicating the patch is activated.
[Source]

When the medicine has all been delivered into your system, the light goes off.  Easy as that.

The beauty of this approach is that it bypasses the stomach and gets into your system a lot faster, which may make all the difference.  It also means no needles, for those who have been using, or have tried to use, injections.

If the patch is successful, we will likely see more migraine meds coming out with a similar delivery system.

If you’re in the USA and would like to get news directly from the source when ZECUITY is available, you can sign up right here.

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Abdominal Migraine in Adults

Abdominal pain – likely a nauseous feeling – recurring again and again.  It can be very hard to get a diagnosis, but it could be abdominal migraine.

Abdominal Migraine in Adults

Abdominal migraine in adults is not often recognized, even though the medical community has been talking about it for almost a hundred years.  Abdominal migraine is well recognized in children, all the more reason why it’s overlooked in adults.  And to be fair, it probably is a rare condition.

As with most types of migraine, abdominal migraine brings on recurring symptoms.  It usually lasts from a couple of hours to three days.

Unlike migraine headache, the pain in the abdomen isn’t one-sided.  It could be very severe, or just a dull ache.  During an attack, there is usually nausea and/or vomiting, or you may become pale and lose your appetite.

To be technically diagnosed with abdominal migraine, there should be no headache associated with the attack.  In other words, instead of headache you have abdominal pain.  However, it’s true that other types of migraine may include abdominal pain as well.

Other characteristics of migraine may be present, such as an aura before an attack.

Abdominal migraine usually starts in childhood and disappears in adulthood (or “changes” into other types of migraine).  But there have been cases of abdominal pain from migraine appearing in adolescence and early adulthood for the first time.

Diagnosis of Abdominal Migraine in Adults

If the above description sounds like you, you’ve taken the first step.  But your doctor will still want to run some tests and rule out other possibilities.

Be sure to tell your doctor how many attacks you’ve had, and what the symptoms were.  She’ll want to rule out various other conditions, such as gallstones, irritable bowel syndrome, infections, and even abdominal epilepsy, which can be quite similar.

A common feature of abdominal migraine in adults seems to be a family history of migraine.  If you know anyone in your family who may have had migraine, be sure to mention that.  Also, your doctor will want to know if you had migraine symptoms when you were younger, or possibly cyclic vomiting syndrome.

Treatment of Adult Abdominal Migraine

Because it is so rarely diagnosed, there’s no standard treatment.  However, there are some treatments which have been used successfully.

Triptans, a common migraine abortive, such as sumatriptan, may be tried.  Pizotifen (pizotyline, Sandomigran, Sanomigran), a serotonin antagonist, has been used for abdominal migraine in adults.  Other migraine treatments such as topiramate (Topamax), calcium channel blockers, beta blockers, and valproic acid (Depakote) may be tried, depending on the patient.  Antihistamines have also been used.

For more information:

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