Headache and Migraine News

21 June 2012

10 Critical Mistakes First Time Migraine Patients Make

You’ve just been diagnosed with MIGRAINE. It’s natural to be confused, maybe even nervous or scared.

I’ve spent many years listening to and helping migraineurs. I’ve found that there are some common mistakes that people make when they’re first diagnosed with migraine. Here are my top 10 – maybe one of them will help you to avoid the same mistake!

Expect fast results. No, actually, don’t expect fast results! It’s true that some migraine patients find a solution right away. But a decent trial period for a new treatment is often 3 months – and that’s just trying one treatment. It’s not just migraine – many neurological diseases require this kind of patience (for example epilepsy or muscular distrophy).
Don’t see the doctor again. After all, it’s "just" migraine. I just need some "painkillers" and a rest and I’ll be fine. No – you should go back to the doctor for follow-up. This especially applies when your symptoms change. But really, because migraine takes time to treat and because it’s a disease with complex symptoms and causes, you should be going back for more help.
Be satisfied with a diagnosis of "Migraine". In 1988, the Headache Classification Committee from the International Headache Society came out with a document intended to classify headache disorders, including many different types of migraine. The latest edition is from 2004. Knowing what type of migraine you have means you can find better treatment faster. When you get a diagnosis, check to see if it’s in the document and if your symptoms match. If not, find another doctor and get a second opinion. (A simplified version of the International Classification of Headache Disorders (migraine section) here)
Rely on popular news reports and commercials for information on migraine treatment. News reports and commercials are important ways to get information out to the public. However, they will almost never give you a balanced view of migraine treatment. That’s why crowds of people go after a "miracle" treatment before trying things that are much more likely to actually work for them. Please take news bites with a grain of salt.
Blame it on "stress". "Oh, it’s just stress – I just need to wait until life calms down a bit." Using stress as a scapegoat has kept many, many migraine patients from proper treatment. Stress does not cause migraine, and there’s some debate about whether it even triggers migraine attacks. It’s a factor in the overall picture, but there are likely other issues that you need to deal with in order to properly treat migraine. It’s not "just stress".
Rely on over-the-counter "painkillers". Instead of making use of medications and treatments that can specifically help migraine, patients often take the "shotgun" approach, and take a general purpose painkiller. This often leads to more symptoms and more pain in the long run.
Think you’ve tried "everything" after three different treatments. No one has tried "everything", because in this day and age there are so many treatments (yes, valid ones) for migraine that it could take a lifetime to give them all a try. Sure, it’s discouraging when you’ve tried 5, 10, 15 treatments over many years. Take a break – but don’t give up.
Rely one one kind of treatment. Only try yoga, or just drugs. Only try vitamins, and ignore the rest. Guess what? Many migraineurs have had great success with a variety of treatments. Medications and a change of diet, or the chiropractor and exercise, or magnesium and biofeedback… Don’t be quick to rule out other types of treatment.
Ignore other symptoms. What other symptoms? Well, a very common symptom of migraine is headache. It’s easy to focus on head pain, and ignore other symptoms. But your doctor can treat you better if she knows about other symptoms you’re having, even if they’re not migraine related. Dizziness? Nausea? Sensitive to light? Neck pain? Depression? And guess what? Many migraine symptoms are experienced between actual migraine attacks. The more you can describe your symptoms, the better treatment you’ll get.
What would you add? Oops – I don’t have a #10 mistake! You have some experience – what would you add as a mistake that people make when they’re first diagnosed with migraine? Leave a comment!

14 June 2012

True Migraine Confessions: June Blog Carnival

James News 0

I haven’t written about the Headache & Migraine Disease Blog Carnival for a while, but you certainly won’t want to miss this month’s offering of "True Migraine Confessions"!

If you’ve ever had to work with a migraine attack, or travel, or if you’ve ever thought about suicide, or simply been completely embarrassed – you’ll find something you can relate to.

So head on over, click the links, and read True Migraine Confessions

12 June 2012

TheraSpecs – Shipping reduced until Friday!

James News 4

I’ve written before about TheraSpecs, an excellent tool to have in your "fight migraine" toolbox.

Well, great news! I just heard from Kerrie Smyres, one of the minds behind the precision-tinted migraine specs, and here’s what she said:

TheraSpecs shipping will be free in the US and international shipping will be half off through Friday, June 15.

So now is the time to grab a deal! More and more people have been using these types of tinted glasses for migraine over the past few months. Thanks to Kerrie and her husband Hart for making them more accessible to migraineurs.

Visit the TheraSpecs website here for more information.

9 June 2012

The Quick Guide to Frovatriptan (Frova and Migard)

James Information, Medications, Treatments 0

Frovatriptan (Frova or Migard) is one of the targeted migraine abortive drugs known commonly as triptans. But not all triptans are created equal.

Many of you know that you can have success with one triptan even after you’ve tried others. Recently, frovatriptan has emerged as one of the most recommended abortives for migraine. So let’s take a closer look…

Frovatriptan (frovatriptan succinate) is a selective 5-hydroxy-tryptamine1 (5-HT1B/1D) receptor subtype agonist. Triptan medications were developed for migraine because of the way they influenced blood vessels, although now we know that they probably fight migraine for other reasons (read more about triptans and migraine here).

Although many think of frovatriptan as a "painkiller", it’s not just a general pain reliever. It’s not prescribed for any pain, but specifically to fight migraine – and not just the pain that often comes with migraine, other symptoms as well.

For example, Frova may fight sensitivity to light and noise, and nausea/vomiting.

Where does frovatriptan excel?

One of the reasons that frovatriptan has become one of the most recommended triptans is because it’s been found to be useful in preventing or treating menstrual migraine (perimenstrual migraine). Since menstrually related migraine affects up to 60% of female migraineurs, that’s a significant chunk of the migraineur population!

Although other triptans work well too, frovatriptan seems to come with a significant advantage. The effects tend to last longer.

That means that there’s less chance of the symptoms coming back. (For example, a study showed that symptoms were 8% more likely to return with frovatriptan, and 21% with almotriptan. Another study compared rizatriptan, zolmitriptan and almotriptan, finding that symptoms were almost twice as likely to return in 24 and 48 hours with these than with frovatriptan).

This is especially important in menstrual migraine, where symptoms do tend to last longer and are more likely to return.

Of course, frovatriptan is not just beneficial for menstrual migraine. For example, this study shows benefits for patients with migraine with aura.

For side effects, frovatriptan seems less likely to cause nausea than some other triptans.

Frovatriptan is often taken per-emptively for menstrual migraine. It’s been compared favourably with preventative topiramate (Topamax) for monthly migraine attacks.

Where does frovatriptan fall short?

Frovatriptan is not necessarily worse than other triptans, just different, which is why it’s important not to give up after trying just one triptan.

Common side effects with frovatriptan include dizziness, headache and tiredness. Other triptans may cause the same side effects, but again trying another triptan may solve the problem for you.

Cautions

Be sure to check with a doctor who knows your medical history before taking this medication. This is particularly important if you you are taking an SSRI (selective serotonin reuptake inhibitor) or SNRI antidepressant drug (serotonin-norepinephrine reuptake inhibitor). Also, make sure your doctor knows if you’ve had issues with heart disease, or if you’re at high risk.

Contraceptive drugs can also interact with frovatriptan specifically and increase side effects – talk to your doctor.

Other medications may interact as well, such as ergotamine medications and propranolol.

How do I take Frovatriptan?

The basic dosage recommendations are similar but different in the USA, Canada, and the UK, so here they are. Remember, these are general guidelines – follow your doctor’s instructions!

Take a 2.5 milligram dose as soon as possible when the symptoms begin. In the USA, the recommendation is to take a second dose after 2 hours, but take no more than 7.5 milligrams in 24 hours.

In Canada and the UK, the recommendation is to take a second dose after 4 hours, but no more than 5 milligrams in 24 hours.

If you experience side effects, or if your symptoms change, or if you’re having to treat more than 2 or 3 attacks per month, talk to your doctor right away. Frovatriptan is not intended for constant usage, and can lead to even more migraine symptoms and other worse conditions.

For more information, see Frovatriptan (Oral Route) (Mayo Clinic), Frovatriptan (Patient.co.uk), and The Pill Book (2012 edition).

6 June 2012

Preeclampsia and Migraines

James Information 0

Is there a connection between preeclampsia and migraines? Or are there special symptoms related to preeclampsia?

Preeclampsia is, of course, a high blood pressure condition that occurs during pregnancy. It can even be a slight increase in blood pressure. Preeclampsia is diagnosed when there is excess protein in your urine. There are other markers in a urine test that can warn you of preeclampsia.

Preeclampsia can put both you and your baby at serious risk. At times there are few or no symptoms, which is another reason why it’s important to have regular checkups during pregnancy.

But what about preeclampsia and migraines? Can this condition actually cause migraine attacks?

There are some clear links between pre-eclampsia and migraine. For example, women taking triptan medications during pregnancy are more likely to develop preeclampsia. At least one study has suggested that women with migraine are more likely to develop preeclampsia in pregnancy.

Changes in the body can certainly trigger migraine attacks in a migraineur. However, the headaches that are caused by preeclampsia are not called migraine headaches, although some of the symptoms may be similar.

There is a specific term for headache and related symptoms in preeclampsia – it has the rather unimaginative name of headache attributed to pre-eclampsia.

And yes, the symptoms can be similar to a migraine attack.

This headache has at least one of these characteristics: It’s on both sides of the head, pulsating, and/or aggravated by physical activity.

A preeclampsia headache will actually develop when your blood pressure is high. Once hypertension has been treated, the headache will be gone within a week.

Some of the other typical preeclampsia symptoms are also found in many migraine attacks. For example:

problems with vision, including loss of vision, blurred vision, and auras
photophobia (sensitivity to light)
nausea
dizziness
anxiety/confusion
abdominal pain

These symptoms can make a preeclampsia look very much like a migraine attack.

Since women with preeclampsia can actually be symptom-free, it can be challenging to diagnose preeclampsia early, especially if you’re not seeing your doctor at regular intervals during pregnancy. However, as always, if you notice any changes in your headache/migraine symptoms, you do need to see a doctor right away. If you’re pregnant, have tests done for preeclampsia. There are actually other factors that can cause a headache with Headache attributed to pre-eclampsia symptoms.

Once these other possibilities have been ruled out, you may have a diagnosis of migraine, or a type of headache. For more on dealing with headache during pregnancy, check here.

If you have migraine and pre-eclampsia, make sure your doctor knows about both conditions. There are some drugs that are used to treat both conditions.

Visit the Mayo Clinic for more on Preeclampsia.