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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Mindfulness Meditation Reduces Suffering In Chronic Migraineurs: Study

Migraine Meditation

Studies Show Meditation Helps Migraineurs (1)

A study conducted by researchers at Wake Forest Baptist Medical Center, Winston-Salem, NC, and Harvard Medical School in Boston, MA, examined 19 adults suffering from chronic migraines in order to find the effects of mindfulness meditation on those experiencing chronic headaches and to test the safety and feasibility of such a practice.

The findings of this study were published online in journal Headache.  Such a test was conducted mainly keeping in mind the hypothesis that stress-trigger in migraines could be addressed mindfulness meditation. As per lead author of the study, Rebecca Erwin Wells, assistant professor of neurology at Wake Forest Baptist, “Stress is a well-known trigger for headaches and research supports the general benefits of mind/body interventions for migraines, but there hasn’t been much research to evaluate specific standardized meditation interventions”. (2)

The study however demonstrated that mindfulness meditation did indeed help alleviate migraine pains and that they were a safe way to reduce the intensity and frequency of the migraines.

Mindfulness-based Stress Reduction or MBSR used yoga, mindfulness meditation and body awareness in a standardized 8-week program on the migraining volunteers. The migraineurs were divided into any of the 2 groups. They were then evaluated on disability, self-efficacy and mindfulness. After this was done, one group received conventional or mainstream migraine management care while the other group took part in the 8-week MBSR program. The MBSR program required the candidates to practice their mindfulness techniques for 45 minutes every day for at least 5 days a week. They were exposed to 1 instruction class every week as well. During this 8-week program all the participants noted how frequent their migraine episodes were, how long they lasted, how intense they were.

The researchers found that the patients who completed the MBSR program tended to have 1.4 fewer headaches per month that were less severe. Not only this, the episodes lasted less longer, were less disabling, the migraineurs felt a better sense of control over the events. Besides this, the program with its techniques proved safe as no adverse side effects were observed during the trial.

However, larger sample sizes and population with varied ethnicity, age groups, gender and socio-economic strata need to be studied for MBSR to be integrated into the mainstream and conventional treatment package for migraineurs.

According to Prof. Wells, “For the approximate 36 million Americans who suffer from migraines, there is a big need for non-pharmaceutical treatment strategies, and doctors and patients should know that MBSR is a safe intervention that could potentially decrease the impact of migraines.” (3)

SOURCES

  1. Image Credit: Woman Doing Yoga On Rock Stock Photo by Adamr; Free Digital Photos; Web September 2014; http://www.freedigitalphotos.net/images/Healthy_Living_g284-Woman_Doing_Yoga_On_Rock_p100414.html
  2. Migraine sufferers may find meditation helps; Medical News Today: Web September 2014; http://www.medicalnewstoday.com/articles/282441.php
  3. Meditation May Mitigate Migraine Misery;Wake Forest Baptist Medical Center – News & Media Resources; Web September 2014; http://www.wakehealth.edu/News-Releases/2014/Meditation_May_Mitigate_Migraine_Misery.htm

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Butterbur Found Effective In Treating Migraines: Studies

butterbur

The Daisy-family Petasites Prove Themselves Effective In Migraine Treatment (1)

Butterbur, Petasites or Sweet Coltsfoot are residents of moist regions like marshes, ditches  and riverbeds and do well in temperate regions in the northern hemisphere. Studies have shown that certain species contain chemicals petasin and isopetasin which occur in high concentrations in the plant’s root and are very effective in treating migraines. 

In my post of April 26th, 2012, titled ‘New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency’ I had outlined how the AAN listed out Butterbur as one of the herbal formulae that they found effective in the management of migraines. (2) 

The organic compound petasin found in butterbur is a combination of the ester of petasol and angelic acid known to stub inflammatory response in the body. It is also a proven muscle relaxant. Moreover, irritable blood vessels that are known to add to the woes of a migraineur are also soothed by petasin and isopetasin by control of blood pressure and spasmodic capillary action. Several German researches have found that incidences of migraines could be reduced by as much as 50% even in long-term patients. (3) 

Here are a list of studies that have expanded on the find: 

  • Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society; AHRQ (US Dept Of Health & Human Services); http://www.guideline.gov/content.aspx?f=rss&id=36897
  •  The First Placebo-Controlled Trial of a Special Butterbur Root Extract for the Prevention of Migraine: Reanalysis of Efficacy Criteria; European Neurology; Diener HC, Rahlfs VW, Danesch U. Eur Neurol. 2004;51(2):89-97. http://www.petasites.eu/PDF/Eur_Neurol.pdf
  •  An extract of Petasites hybridus is effective in the prophylaxis of migraine. NCBI Resources – PubMed; Grossmann M, Schmidramsl H. Int J Clin Pharmacol Ther. 2000 Sep;38(9):430-5. http://www.ncbi.nlm.nih.gov/pubmed/11020030
  •  Petasites hybridus root (butterbur) is an effective preventive treatment for migraine.NCBI Resources – PubMed; Lipton RB, Gobel H, Einhaupl KM, Wilks K, Mauskop A. Neurology. 2004 Dec 28;63(12):2240-4. http://www.ncbi.nlm.nih.gov/pubmed/15623680

Butterbur is available as a herbal tea though it is hard to palate because of it’s bitter taste. However, capsules of butterbur may be a better option. Doctors usually recommend 50-75 mg twice daily as effective prophylactic dosage.

It is imperative that you consult a doctor before taking any butterbur preparation. 

Once advised, choose a brand that says ‘PA-Free’ indicative of the removal of toxic chemical pyrolizidine alkaloid which is toxic to the liver. (4)  

SOURCES: 

  1. Image Credit: Butterbur 628x 323; Spring Allergy Relief; Prevention.com; Web February 2014; http://bit.ly/1nMkgOH
  2. New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency; Migrainingjenny.wordpress.com; Web February 2014; https://migrainingjenny.wordpress.com/2012/04/26/new-guidelines-from-american-academy-of-neurology-on-reduction-of-migraine-frequency/
  3. Butterbur: For Migraines, Allergies, And More; Chiroeco.com; Web February 2014; http://www.chiroeco.com/chiropractic/news/14902/856/butterbur-%20for%20migraines-%20allergies-%20and%20more/
  4. Butterbur In The Treatment Of Migraines; WholesomeOne.com; Web February 2014; http://www.wholesomeone.com/article/butterbur-treatment-migraines

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