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30 May 2018

MWS – Real Treatments Rated, Real Patients Helped

It is so, so helpful to see actual scientific evidence for migraine treatments, and also to see what has actually helped real people – with names.

This combination of scientific studies, along with real case studies, is powerful. Especially in a world where you’re tempted to rely on the last commercial you saw, a YouTube video that was “suggested” for you, or what your local doctor happens to know.

Many of you are already using the 2018 Migraine World Summit library of resources. And you already know what I’ve said about the focused interviews with top migraine experts.

But if you’re still on the fence, you should know about a number of resources that also come with the interviews. Such as:

The new Vitamin and Supplement Guide. What supplements actually work? What is the evidence behind them? What should I beware of?
Patient Case Studies – how much have these actual patients improved, and what has helped them most? Incredible. These aren’t nice stories, they are charts with usable information.
2018 Migraine Treatment Guidelines Summary – again, which treatments have the most scientific evidence behind them? What is most effective? Don’t waste your money on what is “most advertised”… No, these are not just “drugs”!
Trigger Guide – common (and less common) triggers, with lists of practical tips. Not just an article saying “tough luck”.

I’m sure that many many hours of work has been put into this material, which is full of references and details.

These are the kinds of resources that we can use to fight back against migraine in our personal treatment. This is a great way to empower yourself to have more relief this summer than ever before.

To see more details about the complete package, visit the 2018 Migraine World Summit page here.

23 May 2018

Female Sexual Dysfunction and Migraine and Headache Medications

James Uncategorized 0

Just how common is female sexual dysfunction? It’s a complicated question. Although it’s extremely common for women to report some kind of problem sometime, it’s a whole different question when you start asking about actual dysfunction and what that is.

Man and Woman But statistics aside, the problem is real, and in many cases it could be caused by your migraine or headache medication.

Migraine patients, and patients with various headache conditions, often have many symptoms to think about. And, of course, there can be many causes of sexual problems. It’s hard to know what to mention to your doctor, and with sexual activity that may be new or not regular, sexual dysfunction from medication may not be something easily recognized.

Medications can especially interfere with both desire and pleasure during sex. Common culprits include:

Antidepressants: Antidepressants are often prescribed for migraine prevention, even when the patient is not depressed. Common examples of these medications are amitriptyline (Elavil, Entrip, Triptaz, etc), nortriptyline (Pamelor, Allegron, etc), desipramine (Norpramin, Pertofrane, etc), doxepin (Sinequan, Sinepin, etc).
Beta-blockers: Another migraine preventative, beta blockers can cause problems with desire and orgasm, as well as vaginal dryness. Examples include propranolol (Inderal) and metoprolol (Lopressor, Toprol XL).
Calcium channel blockers: As with beta-blockers. Common examples are verapamil (Calaptin, Veramil etc) and nimodipine (Nymalize, Nimotop)
Anticonvulsants: Another migraine preventative. Anti epileptic drugs are commonly prescribed for migraine, and some may be worse than others when it comes to sexual dysfunction. Examples include valproate, topiramate, and divalproex sodium.

Although these are some common categories, there are a number of other drugs that may affect sexual function.

It’s worthwhile noting that many of these drugs will also cause problems for men, though often for different reasons.

If you’re concerned, talk to your doctor. There may be another similar medication that will control your migraine attacks but won’t interfere with sex.

18 May 2018

Big News: First CGRP Inhibitor for migraine Approved in US – Aimovig

James Uncategorized 6

Yesterday, the FDA approved the first of a new class of migraine drugs – CGRP monoclonal antibodies. We’ve been talking about these drugs – and this one in particular, for many years. And it should be available in the USA in a couple of weeks.

Aimovig The drug is being sold as Aimovig, but we’ve known it by its earlier names, AMG 334 and erenumab.

Aimovig, and it has been approved as a migraine preventative. This is what the FDA had to say about it yesterday:

The U.S. Food and Drug Administration today approved Aimovig (erenumab-aooe) for the preventive treatment of migraine in adults. The treatment is given by once-monthly self-injections. Aimovig is the first FDA-approved preventive migraine treatment in a new class of drugs that work by blocking the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks.
[FDA Press Release]

For a somewhat lighthearted basic explanation from 2012, check out The Secret of CGRP.

Aimovig dosage

Aimovig Injector Aimovig is currently a 70mg injection taken each month. Some patients may take a double dose, which would mean two injections of 70mg taken the same day. The injection, done with a pen-like “autoinjector”, is taken in the abdomen, upper arm, or thigh. It’s designed to be injected by the patients, but there are some things to watch for, so talk to your doctor. The injection takes about 15 seconds.

Aimovig Side Effects and Other Concerns

Some of the headlines are claiming that this is a wonderful new side-effect-free medication, which is not strictly true. The side effects do seem to be minimal, which is certainly the general advantage. However, a few patients were irritated by the injection itself. Some also experienced constipation. There are also cautions because of the unknowns of taking Aimovig during pregnancy, and researchers are concerned that there may be an increased risk of preeclampsia.

But for most people, the side effects should be minimal or non-existent.

Advantages of Aimovig

Aimovig seems to be helpful for patients with episodic and chronic migraine, although you will need to discuss with your doctor if your attacks are frequent enough to warrant this type of medication.

As mentioned before, you may experience fewer (or no) side effects with this medication compared to what you have tried before. If you have not used a preventative medication before, your doctor will probably try some other drugs or treatments first before Aimovig.

Aimovig may not prevent all your attacks. If they cut your attacks by a third or a half, that will be a significant improvement.

However, using Aimovig with other treatments could mean a much more significant improvement. And remember, this is only the first of this type of drug to hit the market – other CGRP drugs could work better for you. And there are a whole new class of drugs coming after that.

Another interesting note – this drug is currently being investigated as a possible treatment for hot flashes during menopause.

We will look forward to hearing about your experiences with Aimovig. Once you’ve tried it, come back and comment!

8 February 2018

Are You CoQ10 Deficient?

James Uncategorized 0

Although CoQ10 has been a well known migraine treatment for many years, for whatever reason we haven’t spent a lot of time talking about it here. But a recent article at the New York Headache blog helps us with a summary of information about this treatment.

21st Century CoQ10 — Another brand recommended by Consumer Labs.

CoQ10, or coenzyme Q10, is an antioxidant found in every cell of your body, and also in some foods. It is sometimes listed as a supplement as Q10, vitamin Q10, ubiquinone, or ubidecarenone.

CoQ10 is often taken to fight symptoms of heart conditions. Many people also take it to fight migraine.

The recent article at the NY Headache blog points out that studies have shown CoQ10 benefits for migraine patients, whether children, adolescents, or adults. (Read the article here: Migraines can be prevented with CoQ10 supplementation) The doses given in the trials were 1-3mg for children and adolescents, and 100mg 3x daily for adults.

Dr. Mauskop (author of the post) makes the logical assumption that you’re more likely to benefit from CoQ10 treatment if your levels are actually low. There is a lab test for this, which is often covered by insurance plans. But the post gives the following advice:

It is important to ask your doctor what the actual blood level was because the laboratories will report as normal values between 0.37 and 2.2 (Labcorp) or 0.44 and 1.64 (Quest Diagnostics), studies have shown that the level should be at least 0.7.

Consumer Labs recommends Swanson Ultra as a good budget brand of this supplement (follow the link to “other sellers” and you’ll see that Swanson sells this and it’s shipped by Amazon). The high-absorption recommendation is only slightly more – Doctor’s Best High Absorption CoQ10.

(Note: the “high absorption” version may allow you to get better results with a lower dosage. However, it contains black pepper extract, which may cause issues with some medications, such as propranolol. Talk to your doctor, especially if you’re taking a prescription medication.)

CoQ10 has been helpful for the prevention of migraine for many years. Hopefully with better testing we can match it to the patients who will benefit the most. It’s an inexpensive option that could make a big difference.

27 November 2017

Researchers Looking for Predictors of Botox Success in Migraine

James Uncategorized 1

Excuse the complicated title to this article, but this is what it means in plain language. Botox, or onabotulinumtoxinA, has been very helpful for patients with chronic migraine. But it certainly helps some people more than others. Researchers want to know why, and they also want to know if there is an easy way to predict which patients will respond best to Botox.

Blood Tests and Botox Today, patients need to go through all the treatments before they know if they will work. But what if you could go for a simple blood test which would tell you ahead of time that your treatment had a – say – 87% chance of success? Or maybe a 16% chance of success? That would save everyone a lot of time and money.

A study published earlier this month in the journal Headache found that certain markers may predict Botox success.

First, CGRP levels. We’ve heard a lot about CGRP (calcitonin gene-related peptide) lately, because of the new migraine medications that are coming out. CGRP levels an important part of the trigeminovascular system, and seem to play a role in communicating pain messages in the body. Levels were higher in patients who responded well to Botox treatment. (This is not the first time this has been observed – see Botox and CGRP – and the Future of Migraine Treatment

Second, PTX3 levels. High PTX3 (pentraxin 3) levels have been linked to inflammatory and vascular issues. Patients with higher PTX3 levels were also more likely to respond to onabotulinumtoxinA treatment.

Though this is likely one of many studies that need to be done, this kind of information will not only help us predict who is most likely to benefit from Botox treatment, but should also help us understand both disease and treatment better, so that we can make better options available in the future.

Read the study abstract here: CGRP and PTX3 as Predictors of Efficacy of Onabotulinumtoxin Type A in Chronic Migraine