What Should Work, What Might: Migraine Meds Reassessed

ID-100308698

New Studies Re-assesses Migraine Drug Efficacies (1)

Efficacy of migraine drugs was under another new review from researchers who have examined all of the scientific literature available on the treatment as well as followed up on migraine patients and the scientists have come up with what in their view prove effective in acute cases of migraine. Besides these 2 criteria the study was also based on the depth of the published research done on the medications as well as the quantum of studies on them.

The conclusions of the new study at a glance are:

DEEMED EFFECTIVE (LEVEL A) PROBABLY EFFECTIVE (LEVEL B)
TRIPTANS – Sumatriptan, Zolmitriptan, Rizatriptan, Frovatriptan, Almotriptan, Naratriptan, Eletriptan, Avitriptan OPIOID – Codeine+Acetaminophen, Tramadaol+Acetaminophen
Dihydroergotamins
NSAID – Aspirin, Ibuprofen, Naproxen
OPIOID – Butorphanol Nasal Spray
Caffeine with NSAIDS

Findings of the study were published in the January 2015 issue of the medical journal Headache. As per Dr. Stephen Silberstein , professor of neurology and director of the Jefferson Headache Center of Thomas Jefferson University in Philadelphia, “We hope that this assessment of the efficacy of currently available migraine therapies helps patients and their physicians utilize treatments that are the most appropriate for them.” (2)

Based on the study criteria, drugs were thus rated as deemed effective (Level A), probably effective (Level B), possibly effective (Level C). For such medications where the proof was found either inadequate or gave such results which refutes the use of that medicine, was classified as Level U. For a drug to be classified as deemed effective or a Level A drug, the studies done on the drug must be supported by at least well-designed, double-blind, randomized, placebo-controlled clinical trials.  (3)

The American Headache Society will soon be translating the research findings that will aid in providing evidence-based guidelines to clinical practice. In any case, doctors treating migraine patients must consider the individuals on a case to case basis keeping in view the drug side-effects, patient history, costs and drug efficacy.

SOURCES

  1. Image credit: Pills and Capsules – Stock Photo; freedigitalphotos.net; Web February 2015; http://www.freedigitalphotos.net/images/pills-and-capsules-photo-p308698
  2. Study Rates Migraine Medications; WebMD.com; Web February 2015; http://www.webmd.com/migraines-headaches/news/20150120/study-rates-migraine-medications
  3. American Headache Society Provides Updated Assessment of Medications to Treat Acute Migraine; Newswise.com; Web February 2015; http://www.newswise.com/articles/american-headache-society-provides-updated-assessment-of-medications-to-treat-acute-migraine

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Finally A Stroke Guideline For Women!

Brain-Haemorrage

Hemorrhagic Stroke Risk In Women Addressed By AHA/ASA For The First Time (1)

Recent research has shown that migraineurs and especially those who experience aura are at an increased risk of a stroke (brain hemorrhage) or a heart attack during a migraine episode. My post of June 20th, 2013 speaks of this research (on high risk of stroke among the migraining population): http://bit.ly/1iON349

A stroke may be either ischemic or hemorrhagic in nature. A hemorrhagic stroke is the rupturing of an artery in the brain which results in bleeding in the tissues surrounding the rupture and killing the brain cells there which are devoid of blood, oxygen and nutrition. An ischemic stroke occurs when there is an obstruction like cholesterol or clot in the arteries in the brain. These account for almost 90% of all strokes and are less likely to result in fatality if given immediate attention. However, migraineurs are more susceptible to the deadlier hemorrhagic strokes. (2)

[Read WebMD research on how women with migraine with aura may be at increased risk for an additional type of stroke called hemorrhagic stroke here: http://bit.ly/1cmHW6Y ]

Given that women are more susceptible to migraines with aura, the higher risk of getting a stroke is inherent yet there have been no guidelines to date to address stroke issues in women. Finally a guideline has been issued by The American Heart Association/American Stroke Association for health professionals to prevent strokes in women. Here are a few of the important recommendation highlights you should know:

1. FOR MIGRAINEURS

“Women are four times more likely to have migraines than men, and they often coincide with hormone swings. Migraines alone don’t raise the risk of stroke, but ones with aura do. Using oral contraceptives and smoking raise this risk even more, so the guidelines urge stopping smoking.” (3)

2. FOR ELDERLY WOMEN

Women over 75 years of age should be screened for atrial fibrillation as it is an increased stroke risk factor.

3. FOR WOMEN WITH HYPERTENSION/ HIGH BLOOD PRESSURE

Low dose aspirin or calcium supplement therapy is recommended to cut of stroke risk

4. WOMEN WITH PRE-ECLAMPSIA

Preeclampsia is a condition where a pregnant woman experiences both high blood pressure and a significant increase in protein in her urine. Women with preeclampsia are twice as likely to get a stroke and four times as likely to suffer from high blood pressure later in life. In addition, they are to be treated for weight and cholesterol issues as well as smoking.

5. PREGNANT WOMEN:

Such women who are pregnant and suffer from high blood pressure (>=160/110 mmHg) should be given medication for high blood pressure. Those who are expectant are to be treated for readings in the range of 150-159 mmHg/100-109 mmHg. (4)

SOURCES

  1. Image Credit: Brain Hemorrhage; Sanitarian.net; Web February 2014; http://www.sanitarian.net/wp-content/uploads/2010/11/Brain-Haemorrage.jpg
  2. Study Shows Increased Risk of Heart Disease and Stroke for Migraines With Aura; WebMD.com; Web February 2014; http://www.webmd.com/stroke/news/20100824/migraines-with-aura-may-raise-stroke-risk
  3. Guidelines For Stroke Prevention In Women Issued; Forbes.com; Web February 2014; http://www.forbes.com/sites/robertglatter/2014/02/09/guidelines-for-stroke-prevention-in-women-issued/2/
  4. Stroke prevention in women: guidelines set for the first time; Medical News Today; Web February 2014; http://www.medicalnewstoday.com/articles/272351.php

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