New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency

New guidelines or strategy if you will, have been chalked out and released by scientists at the American Academy of Neurology in conjunction with the American Headache Society on the approach migraineurs should take to reduce the frequency of their attacks. These guidelines have been released just this week and basically are a little different from the previous guidelines in terms that they reduce the ranking of certain migraine drugs (such as Verapamil and Gabapentin) which were highly recommended in the last guidelines due to evidence gathered against them. In addition, the new guidelines are based on evidence-based research on a larger population than were done for the last set of guidelines covering various demographics – gender, races etc. (1)

Want Fewer Migraine Attacks? Follow a Preventative Regimen Everyday (2)

As per the neurologists, almost 38% of all migraineurs should follow a preventative strategy to reduce the number of their migraine episodes. But only a third of that percentage followed a daily preventative regimen with the rest of them only resorting to band aid approaches and tackling the pain once they are in the throes of a migraine attack or are expecting one within a few hours. The approaches they often took were such as were not proven effective in scientific testing before.

According to Mark Green, MD, director of the Headache Center at Mount Sinai School of Medicine, in New York, “What the guidelines do is pinpoint first-line treatments based on evidence and effectiveness.  If these guidelines are used widely, we will be able to up the odds of reducing headaches by 50 percent. Moreover, the stakes may be high if we undertreat migraines. Evidence is building to suggest that if we allow migraines to progress, the frequency of attacks may increase, and they may also become harder to treat” (3)

Here’s a quick look at what the evidence-based preventative guidelines suggests to migraineurs:

  1. First line prescription drugs must be taken on a daily basis to bring down the number and intensity of the attacks.
  2. Effective For Prevention: Anti-seizure medications Divalproex sodium, Sodium valproate, Topiramate, Metoprolol, Propranol, Tumolol.
  3. Effective Herbal Preparations: Butterbur / Petasites.
  4. Probably Effective: Nonsteroidal anti-inflammatory drugs or NSAIDS such as Fenoprofen, Ibuprofen, Ketoprofen, Naproxen, Naproxen Sodium, Subcutaneous histamine, Complementary treatments, Magnesium, Riboflavin, Feverfew.
  5. Found Not Effective: Anti-seizure drug lamotrigine was not effective in preventing migraine.

SOURCES:

  1. New Guidelines Assert That Daily Preventive Therapies Significantly Reduce Migraines; Newswise; April 2012; http://www.newswise.com/articles/view/588495/?sc=rsmn&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewswiseMednews+%28Newswise%3A+MedNews%29
  2. Image by Ambro; Freedigitalphotos.net; April 2012; http://www.freedigitalphotos.net/images/view_photog.php?photogid=1499
  3. New Guidelines: Treatments Can Help Prevent Migraine; American Academy of Neurology (AAN); April 2012; http://www.aan.com/press/index.cfm?fuseaction=release.view&release=1062

Video of the 2012 AAN Conference may be accessed at:

  1. 2012 AAN Press Conference: New Guidelines on Preventing Migraine Headache; YouTube.com; April 2012; http://www.youtube.com/watch?v=LoKPwq9JcKE&feature=g-upl&context=G2423319AUAAAAAAAAAA

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De-mystifying Migraines In Women

I was struck by the statistics on migraineurs worldwide published by the WHO. Apparently, 303 million people the world over suffer migraines, out of which women account for 70% of the patients. India alone has 100 million sufferers and the US has 30 million patients. The report went on to add that it is estimated that 20 million migraine attacks happen everyday!!!! Staggering by any scale.

Though a lot of cutting edge research has been done, especially in the last decade to control this beast, scientific reports still grapple with unknowns, and are still clueless on issues such as why or how magnesium release regulates calcium ions in the neurons or why a certain chain of events takes place in the cranium that bring on migraines or even why they wind up.

With so much still in the grey, one wonders when and if help will come from drugs that will be safe to consume in the long run or if there are any strategies out there to shake this neurological disease.

In my book, ‘Migraines for the Informed Woman’, I have attempted to simplify the esoteric jargon of research papers and scientific material on migraines. After more than one decade of trying most therapies, I have come to the conclusion, that some work and others that are not as effective. More importantly, I have come to realise that certain mixes of therapies done simultaneously work wonders.

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