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Attention given to HIV Patients with Migraine in new study

James — Fri, 03 Feb 2012 16:45:33 +0000

A University of Mississippi study is drawing attention to migraine in HIV patients. The study, first published online in November, points out that chronic migraine is a chronic problem for those with HIV.

200 HIV / AIDS patients were a part of the study. 53.5% reported headache symptoms. 14.56% met the criteria for episodic or chronic tension-type headache. And a whopping 44% were diagnosed with migraine – with 27.5% meeting the criteria for chronic migraine.

27.5% with chronic migraine is very significant. In fact, it means that those with HIV/AIDS are 13 times more likely to have chronic migraine than the general population.

And that’s not all. The more severe the HIV disease, the worse and more frequent the migraine attacks became. However, duration of the disease and number of prescribed antiretroviral medications did not make a significant difference.

This study certainly highlights the need to study the relationship between HIV and migraine, but it also helps to zero in on treatment of symptoms for HIV patients. Often, because of the HIV disease, other issues are suspected when the patient has headache pain. But now we know that tension-type headache and migraine are extremely common. Hopefully this will help patients get the proper treatment sooner.

The researchers also had an interesting side note. More often than usual, patients with HIV/AIDS had migraine attacks with some atypical features- for example, a two-sided migraine, or migraine with a pressing/tightening quality. The researchers still felt comfortable diagnosing these as migraine based on other criteria. But some doctors might miss a connection due to somewhat abnormal symptoms.

via: Research Yields Insights About HIV-Related Headaches

From the Headache and Migraine News Blog

Attention given to HIV Patients with Migraine in new study

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The Case of the Missing Studies: Patients missing critical information

James — Wed, 18 Jan 2012 21:12:10 +0000

Clinical trials are tricky – one can say one thing, one can say another. But what if people with a financial interest could hide the ones you didn’t like, and only use the ones you did like?

A series of studies in the British Medical Journal suggest that clinical trials are missing – trials that may say something quite different than what the public is hearing.

In the United States, the government is trying to tighten up on requirements for clinical trials. One of these regulations is that all eligible clinical trials must be reported (on ClinicalTrials.gov) within one year of the study’s conclusion. This came into effect in 2007.

This database has an impressive list of studies – currently 119,213 trials from 178 countries. So whether or not trials are reported truly has a global impact.

So has the new requirement solved the problem? Not a chance. One study found that only 22% of the eligible trials had been reported after 12 months! (see Compliance with mandatory reporting of clinical trial results on ClinicalTrials.gov) Another study found that 50% of trials funded by the National Institutes of Health were published after 30 months, and a third of them were still unpublished after 51 months. (see Publication of NIH funded trials registered in ClinicalTrials.gov) Yes, that’s over 4 years!

Another study found that even when studies were reported on Medline (an online database of trials), they weren’t properly tagged and indexed. (see Understanding why evidence from randomised clinical trials may not be retrieved from Medline)

–>>> This means basically that someone could do a well-designed clinical trial related to cluster headache or migraine, then not report the results for a few years. Even when they do report it, they can leave off tags so that no one can find it. Even if they do find it, many will miss studies that are so old.

Why is this happening? Don’t scientists want to publish their work?

Admittedly, some of this could come from a misunderstanding of the rules, laziness, simple mistakes, and so forth. There’s also time and expense to consider – it may be easier for a large company to publish than a smaller one with limited resources.

But the reality is that many of these studies are sponsored by the companies that sell you the medication you use. If a study says something the drug company doesn’t like – the study may just disappear. And that’s a scary thought.

Often researchers will publish a meta-analysis of the available studies. For example they could take the data from 12 trials of a certain drug, and tell us that, according to 8 of the studies, the drug is very effective. That sounds good until you realize there could be 12 more trials out there somewhere that say the opposite. One study found just that – the missing data often contradicted what the meta-analysis studies were telling us. (see Effect of reporting bias on meta-analyses of drug trials: reanalysis of meta-analyses)

The answer isn’t easy. Clinical trials can be tricky to regulate. And it’s even harder if you’re a small fish playing in the same pond with the huge drug companies.

But if the rules are there, they need to be enforced. And the public needs to know when they’re not being enforced.

The world of clinical trials is not as pure, easy to understand, and efficient as many people believe. It’s more important than ever for the buyer to beware – do your own research, be cautious, and don’t believe everything you read – even if it’s in a medical journal. What’s missing may change a whole lot.

From the Headache and Migraine News Blog

The Case of the Missing Studies: Patients missing critical information

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Exercise Fights Migraine (a study of comparison)

James — Mon, 19 Dec 2011 21:51:47 +0000

It shouldn’t be surprising that exercise is a migraine-fighter, but a recent study published in the journal Cephalalgia in October helps to put the benefits in perspective.

Walking – an excellent way to start

The study of 91 women who had migraine attacks with headache 2-8 times per week. The migraineurs were split into three groups. One group was given topiramate (Topamax), the next was put in a relaxation program, and the last group in an exercise program.

Which helped the most?

Over a three month period, with a follow-up of 3 and 6 months. The surprising result was – that all three groups experienced about the same benefit.

Some patients even found that their symptoms dropped by 75% – a remarkable improvement for any kind of treatment of such frequent migraine attacks.

Considering the possible side effects of topiramate and other medications, and the additional and long term benefits of exercise, it’s clear what we should be focusing on here.

I admit I was surprised at the language of the doctoral student who carried out the study, Dr. Emma Varkey. She says,"Our conclusion is that exercise can act as an alternative to relaxations and topiramate when it comes to preventing migraines, and is particularly appropriate for patients who are unwilling or unable to take preventative medicines."

So we take medicines, and if that doesn’t work we go the alternate route of exercise? I think that this study and a mountain of related research should be putting things the other way around. Let’s find wise, safe ways that migraineurs can exercise, and help them long term, instead of taking money out of their wallets and encouraging them to rely on a pill.

For many migraine patients, it’s going to be a combination – exercise, medication, and other treatments such as relaxation techniques. We need to look to long term benefits and treatment as well as short term relief.

Read more about headache and exercise here, and then get started with these Headache exercise tips…

More on the study from Science Daily: Exercise Just as Good as Drugs at Preventing Migraines, Swedish Study Suggests

From the Headache and Migraine News Blog

Exercise Fights Migraine (a study of comparison)

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Triptans and Heart Disease – A Dangerous Mix!

James — Thu, 15 Dec 2011 16:49:41 +0000

Triptan medications such as Imitrex, Frova, and Relpax are still an important part of migraine treatment. But for people with a risk of heart disease, they can be dangerous.

At the annual meeting of the American Neurological Association in September, a surprising and disturbing study got a lot of notice. It was all about the prescription of triptan medications.

The study included 120,000 migraine patients. Now, triptans are not recommended for those with certain types of heart disease. Did doctors follow this recommendation?

The surprising result was that 1 in 5 patients with heart disease was prescribed a triptan medication!

That’s right, 1 in 5. Why? Did the doctor not know about the patient’s medical history? Was the doctor not aware of the dangers triptans pose to these patients?

Triptans can narrow blood vessels by 10-20%, and those of you with experience with heart disease know just how dangerous that can be.

Not only should your doctor know your medical history, she should also know your risk of heart disease. If you know you have multiple risk factors, even if you’ve never had problems with heart disease, you should think twice about taking triptan medications.

Dr. Arthur Elkind, president of the National Headache Foundation board of directors, particularly notes that you should be aware of elevated lipid levels, hypertension, a history of smoking, history of angina pectoris, and heart attack.

Though triptans are considered generally safe for most migraineurs, there is a lack of care being taken for patients who are at risk.

From the Headache and Migraine News Blog

Triptans and Heart Disease – A Dangerous Mix!

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Your Tips – Music and Headache

James — Sat, 10 Dec 2011 14:46:44 +0000

Do you use music to prevent or treat a headache or migraine attack?

Sure, we all know that music can make us happy or sad or whatever. But Dr. Luciano Bernardi from Italy’s Pavia University believes that music may also have a direct impact on your cardiovascular system. In other words, it’s not just that emotions affect your heart – it’s also that your heart may affect your emotions – and music affects both directly.

In a study using classical music published in 2009, Bernardi’s team found that music had an impact on respiration rates, blood pressure, circulation rhythms, and the narrowing of blood vessels.

Diseases such as migraine do involve a complex relationship between what happens in the brain and neurological system, and the heart and blood vessels. Could this subtle influence that music has on physical responses become a part of migraine treatment?

Scientifically speaking, the answer would appear to be – yes, but it’s not that simple. Music has a very complex, ever-changing influence on the body. It may not be easy to discover and then prove in a lab just how it can be used in treatment.

In complex cases like this, you often have a head start, because you know your own body and are aware of its subtleties – even if you’re not always conscious of them.

So back to you – have you found music to be helpful? How? Is it a preventative? A coping strategy? Has it ever been a help during a migraine attack? What about various types of headache disorders?

Share your comments below!

From the Headache and Migraine News Blog

Your Tips – Music and Headache

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Too Much Tylenol – Over Time?

James — Sat, 03 Dec 2011 01:42:56 +0000

Hopefully most people are aware of the dangers of taking too much paracetamol / acetaminophen. Sometimes people are taking different products that both contain acetaminophen – and inadvertently take too much. It can be very dangerous.

But what about a "staggered overdose"? That is, people who are taking a little too much over a period of time – could they be just as bad off, or even worse off?

Yes, say researchers – a little-by-little overdose could be even more serious than a one time large overdose – and it could be just as life-threatening.

Researchers at Edinburgh University studied the cases of 161 patients who had come to the hospital there over a 16 year period. They also looked at cases of 663 patients with paracetamol/acetaminophen overdose. Those with the gradual overdose were more likely to develop liver and brain problems, need kidney dialysis, or help breathing. The overdoses were also more likely to be fatal.

To make matters worse, the blood test that would identify a one-time overdose will not identify the staggered overdose. Meaning that it will be easy for your doctor to miss.

The message is clear – follow the instructions on the label, check the ingredients of medications you’re taking, and if you need more pain relief, see a doctor. Just taking "a little more" of something to see if it relieves the pain is not the answer.

From the Headache and Migraine News Blog

Too Much Tylenol – Over Time?

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Steroid Injections cut Cluster Headache Attacks

James — Thu, 01 Dec 2011 17:28:58 +0000

This past October, The Lancet Neurology published a study from France using steroid injections for cluster headache patients. Though certainly not the silver bullet for cluster, the treatment did show promise.

The study featured patients who were having at least 2 cluster headache attacks per day. Patients were randomly chosen to take an injection of corticosteroids or a placebo (saline solution). The injections were suboccipital (in the back of the head/neck – the greater occipital nerve), on the same side as the cluster symptoms. All patients were taking verapamil.

Compared to the group on the placebo, patients had on average half of the cluster headache attacks over the next 15 days. Other than some neck pain where the injections were done, there were no side effects recorded.

Both chronic and episodic cluster headache sufferers were a part of the study.

For a condition that has so little available treatment, steroid injections may be a good option to help control cluster attacks.

Hear a doctor’s comments on the study here: Steroid Injections for Cluster Headache?

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Are Your Supplements and Vitamins Shortening Your Life?

James — Sat, 12 Nov 2011 14:53:33 +0000

A study of 38,000 women suggests that taking certain vitamins may shorten your life. Supposed culprits included migraine-fighting magnesium. So the question is – could that migraine-fighter be killing you?

The truth is, you probably have very little to worry about if you’re taking vitamins responsibly. Here’s why.

First, the study wasn’t controlled for every health factor. How could it be? For example, what if a disease shortens your life, and you’re taking vitamins for that? Although some such variables were checked, there are just too many unknowns.

Second, the study relied on the memory of each person. How accurately do you think each participant could remember exactly how what vitamins they took over a lifetime?

And think about this – are people who take more vitamins generally just as healthy as everyone else? Many are taking a supplement because they already don’t feel as healthy as the average person. In addition, a recent study at Psychological Science suggested that many who take vitamins feel they can "cheat" in other ways – skipping good exercise or diet choices.

In the end, this study isn’t giving a lot of solid answers. However, it is true that often vitamin-taking isn’t as helpful as people think. So should you stop taking your vitamins?

You should probably stick to the vitamins – if you have a good reason for taking them. That doesn’t mean a vague idea that more vitamins is better. Instead, it means doing your research and finding out what’s worthwhile to take. For example, the research clearly shows the benefits of magnesium for migraineurs. If it helps you, the benefits of cutting down on migraine symptoms could very well lengthen your life, not shorten it.

Do know why you’re taking your vitamins – then make healthy choices in the rest of your life. Proper rest, good exercise, and a healthy diet are generally going to be far more important that which vitamins you do or do not take.

Finally, be sure to take good quality vitamins. We often talk about which supplements and vitamins to take – which brands, etc. Do your research. A cheap alternative may be useless when a more expensive brand you can’t find at the local pharmacy may be just what you need.

Is this study proof you should stop taking your vitamins? No way. But take them wisely.

via: Vitamins linked with higher death risk in older women

From the Headache and Migraine News Blog

Are Your Supplements and Vitamins Shortening Your Life?

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Botox and Quality of Life: Does it really help?

James — Thu, 10 Nov 2011 14:28:59 +0000

Of course there is no treatment that helps everyone, but another study (published in Neurology) has shown that Botox treatment for migraine does help some – and help them in real ways.

You see, some treatments and medications can really cut down on the number of migraine attacks someone has, and yet not really be worth it – because of the side effects. So this study set out to check on patients’ "health-related quality of life". Overall, is their health really better?

1,384 patients were involved in the analysis using a migraine related quality of life questionnaire and the Headache Impact Test (HIT). Compared to a placebo, the quality of life of migraine patients was significantly improved while taking Botox (onabotulinumtoxinA).

Now, this study was funded by the makers of Botox, which is not unusual, but important to note. The company has certainly had its ups and downs when it comes to this migraine treatment.

However, this does support other studies and the testimonials of specialists who are treating patients. And the study was carefully done by well known experts in the field. Botox certainly seems to be a real help to some, and yet there are still important questions about who will benefit most from treatment and how treatment should be done. And in spite of the evidence, many insurance companies are still reluctant to cover a treatment which tends to be expensive.

Hopefully studies like this will provide them with the evidence they’re looking for.

The study can be found here: OnabotulinumtoxinA improves quality of life and reduces impact of chronic migraine
via: Botox improves quality of life

From the Headache and Migraine News Blog

Botox and Quality of Life: Does it really help?

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Cluster Headache and Sleep: is sodium oxybate the answer?

James — Tue, 13 Sep 2011 22:47:18 +0000

A new study in Neurology suggests that sodium oxybate may be one of the future drugs for cluster headache sufferers.

We’ve long known about the connection between sleep disorders and cluster. But typical medication for sleep has not been the miracle solution for cluster. But sodium oxybate may be the exception to the rule.

Sodium oxybate is a type of drug known as a central nervous system depressant. It’s used to help prevent daytime sleepiness in patients with narcolepsy (a sleep disorder – read about narcolepsy here). Though we don’t know exactly how it works, it does help with sleep patterns.

The four patients in this long term study responded very well to the drug – their cluster attacks during the night drastically decreased and were less intense when they came. Obviously, patients also slept better!

The results are very positive, and there’s great hope that this will help many other cluster patients. Though the study was small, it must be remembered that this is a rare condition and, again, the results were very promising in all four patients.

Be sure to talk to your doctor about this option, and only get the drug from recognized sources, where it is pure and properly labelled.

via: New drug for cluster headaches

From the Headache and Migraine News Blog

Cluster Headache and Sleep: is sodium oxybate the answer?