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New Clues about Medication Overuse Headache and Opioids

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In the video below, researcher Dr. Julie Wieseler discusses new research into the opioid medications.

Opioids include medications such as codeine and meperidine (Demerol).  They’re common when it comes to migraine treatment, but they’re also highly suspect when it comes to Medication Overuse Headache (MOH).  Meaning – taking them for migraine symptoms can temporarily help, but make symptoms worse later on.  (Actually, most medications can do this – but opioids seem to be among the more likely)

Researchers have noticed that taking opioid medications can make symptoms of cutaneous allodynia worse – but why?

The investigation began to see why exactly this migraine treatment was causing more symptoms in the long run.  Their results, discussed in the video below, may help researchers find better treatments, or use opioids more safely, or find ways to prioritize treatments that are less likely to cause MOH.


Find out more about this new research here:  Why Opioids Enhance Migraine Pain:  The Puzzle Points to Glia

Triptans and Heart Disease – A Dangerous Mix!

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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.

Too Much Tylenol – Over Time?

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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.

To read more, see:  Paracetamol warning: ‘Slightly too much can cause overdose’

Why Migralex was Developed

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This is a very brief video from Dr. Alexander Mauskop of the New York Headache Clinic explaining why Migralex was developed.  Migralex is an abortive that many of you are familiar with.  It’s been helpful for many people with migraine and headache, and it’s available without a prescription.

Migralex works well for some because the whole is more than the parts.  Very often, an individual ingredient (ie aspirin, magnesium…) won’t help.  But a carefully measured combination of ingredients can make all the difference.

It’s important to emphasize that this is not an excuse to avoid seeing a doctor!  But Migralex may be helpful for someone under a doctor’s care, or someone who has the symptoms that so far are not being effectively treated by their doctor.

Read more reviews of Migralex here. It can also be purchased through the link.

Botox and Quality of Life: Does it really help?

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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

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The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.