James

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Posts by James Cottrill:

6 March 2017

Candesartan for Migraine

Recently a HeadWay subscriber mentioned a treatment that has been working well for her, and I realized that I haven’t mentioned it before. So here is a brief description of candesartan and its use in migraine treatment.

Candesartan is sold under the brand names Atacand, Amias, Blopress, and Ratacand, although it’s also available as a generic drug. It’s classified as an angiotensin II receptor blocker (ARB). ARBs are often used to treat hypertension, and candesartan is no exception. But antihypertensive drugs are also used as migraine preventatives.

In 2013, a study compared candesartan with a more common migraine preventative, propranolol. The study concluded that 16mg daily of candesartan was comparable to 160mg of propranolol – both led to fewer days with migraine symptoms. (see A comparative study of candesartan versus propranolol for migraine prophylaxis)

Sometimes we make the mistake of thinking that just because we’ve tried a certain kind of drug, we shouldn’t bother trying similar drugs. But the truth is that every drug – even sometimes different versions of the same drug, can have a different effect on an individual. That’s why candesartan can help a patient when propranolol might not, or vice versa.

As always, talk to your doctor before trying any medication. You may not need 16mg – a lower dose may be helpful. Candesartan is NOT for use by anyone who may be pregnant.

Another bit of good news is that candesartan may be a better option for patients concerned about weight gain.

If you’re interested in trying a new preventative medication, talk to your doctor about candesartan. It’s now an often recommended option.

2 March 2017

Vitamin B2 (riboflavin) for Migraine

James Treatments 1

Vitamin B2, otherwise known as riboflavin, has long been a recommended supplement for migraine. Over the past couple of years, studies have continued to show the benefits of B2 for adults, although there has been less evidence for its use in children (see also Supplements as Preventatives for Children – what works?).

Some studies have even found that its comparable to certain common drug treatments (see this study comparing riboflavin to sodium valproate, leading some researchers to recommend it as a safer option as compared to more mainstream migraine medications.

But vitamin B2 still seems to shine most when used in conjunction with other complimentary and traditional treatments. Hence the popularity of combo supplements such as MigreLief. See also some of our visitors comments in Magnesium for Migraine 2 – Combos?

A common recommendation for migraine patients is 400mg of B2 daily. It’s wise to check with your doctor before trying any new treatments.

Recently, ConsumerLab.com did a test of various vitamin B supplements. They tested only two brands with B2, but they both passed quality tests. They were the PipingRock.com brand, and Nature’s Way. The PipingRock.com version was at time of writing less expensive, while according to ConsumerLab.com the Nature’s Way version had the advantage of being gluten free and avoiding other common allergens such as soy and dairy. Both come in 100mg capsules.

Check out this randomized controlled trial, which found patients taking riboflavin had 50% fewer migraine attacks than those taking the placebo: Effectiveness of high-dose riboflavin in migraine prophylaxis.

27 February 2017

Do Polarized Lenses make you dizzy, or give you headaches?

James Information 7

A quick search online will tell you that there are people concerned about getting dizzy, nauseous, or even experiencing headaches when wearing polarized lenses. On the other hand, a vast majority seems to find either no effect or even relief from headache symptoms while wearing polarized lenses. So what’s the story?

Polarized lenses - do they cause dizziness? Polarized lenses are used in some sunglasses in order to cut down on glare. Anyone who has experienced migraine knows that glare can be like a knife going through your head. Thus, quality sunglasses are popular with migraine sufferers.

Although those marketing sunglasses are naturally anxious to defend their products, there are good reasons to believe that the polarization itself, in a majority of cases, is probably not the culprit.

First, as already mentioned, migraine patients are much more likely to appreciate quality polarized lenses than to avoid them. Secondly, because quality sunglasses (such as these) tend to be expensive, cheap versions are often purchased which may have distortions in the lenses – and this certainly could lead to the symptoms mentioned above.

Also, any new lenses, especially (but not exclusively) prescription sunglasses, do take time to get used to. At first, any new lenses may cause some unwanted symptoms.

Do these things explain everyone’s complaints of headache or dizziness from polarized lenses? Probably not, which is why it may be something worth studying in a clinical trial.

However, for most migraine patients, quality polarized lenses are probably going to be a benefit, if you give them a little time. In fact, there are polarized lenses especially designed for migraine patients. And lessening migraine symptoms are not the only benefits.

Have you experienced any strange symptoms only when wearing polarized sunglasses? What have you done that has helped? Leave a comment!

23 February 2017

10 Headache and Migraine News Highlights from the past 3 Months (February 2017 edition)

James Highlights 0

Thanks to all of you for visiting and taking part in the conversation over the past 3 months! Here are the posts that have been most popular with visitors to Headache and Migraine News, with the most popular posts first. The three posts in bold are the posts that received the most “likes” on Facebook. I hope these have been a help to you!

20 February 2017

Migraine Experts Remain Skeptical of Acupuncture

James News, Treatments 1

A report last year suggesting that the benefits from acupuncture “persist” long term has led to some interesting discussion among migraine experts. An interesting theme of their comments – they might recommend acupuncture, but they’re still skeptical.

Acupuncture: Experts Skeptical Many migraine clinics and professionals seem reluctant to speak out against acupuncture. Part of the reason is that they see few or no side effects, which is a good start. But acupuncture is also very heavily promoted, and many patients swear by it and would not appreciate hearing anything against it.

The study released in October (The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain.) drew on earlier studies. However, as has been noted again and again, these studies are not as reliable as many of the medical trials we’re familiar with.

Dr. Richard Lipton pointed out once again that “blinding” is difficult – in other words, how do you make someone “think” they’re receiving acupuncture when they’re not (an important part of blind clinical trials). One of the most often cited trials showing benefit from acupuncture for migraine did use “fake” acupuncture, but concluded that Treatment outcomes for migraine do not differ between patients treated with sham acupuncture, verum acupuncture, or standard therapy. In other words, just stick the needles anywhere.

Long term studies of acupuncture for migraine remain nonexistent. Dr. Dawn C. Buse notes that some studies may simply reflect that patients who apparently benefit from acupuncture are actually more self sufficient and willing to try new treatments – in other words, it’s not the acupuncture, it’s the overall way of life.

But if some studies seem to show that acupuncture may compare to more traditional treatment, why doesn’t everyone use it?

Some of the reasons include:

Poor clinical trials (as mentioned above), or trials with mixed results, and therefore a lack of confidence in the results.
Emphasis on a combination of treatments. Most specialists are positive about complimentary treatments, but most of these treatments work best along with more traditional treatments. Acupuncture isn’t the cure.
Many other good options. Although acupuncture tends to get a lot of press, there are many, many non-traditional and complimentary treatments available. Many specialists simply put acupuncture further down the list, feeling that there are better options.
Expense and time commitment. Even Dr. Alexander Mauskop, who is a licensed acupuncturist, admits to treating very few patients with acupuncture. For one thing, acupuncture is not likely to be covered by insurance. And it takes time – one of the cited studies, for example, had patients in for acupuncture 5 times a week. If you need to go 5 times a week, to actually get a benefit, would you do it?

Between studies with mixed results, time and expense, and many other and often better options, many specialist would agree with Dr. Deborah I. Friedman: “In general, I don’t discourage it, but I rarely suggest it …”