The Migraine Headache Blog from Headache-Adviser.com

The Migraine Headache Blog will keep you in touch with the world of headache medicine.

As a Headache-Adviser, from me you will get information on new treatments or a "hot topic" in headaches.

You will also get patient scenerios, and how they were managed.

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Jul 8, 2008, Dehydration Headaches

As most of the country right now is under heat wave after heat wave, don't forget that dehydration may be a trigger for migraine.

With less fluid in the body, your system will make less fluid to surround your brain. This is a daily normal occurance and you usually make about 500cc to cushion the brain so to speak. But if you don't have enough fluid, maybe you make only 475?

That small dip is enough to irritate things and start a headache.

So the obvious answer here, is that just like other lifestyle changes, migraineurs must have a bit of a rigid life in terms of habits. Carry that water bottle and drink two or three per day to stay headache free.

Jul 1, 2008, Sumatriptan Available In Two New Delivery Systems

One of the great things about attending a scientific meeting like the one in Boston this past week for the AHS, is seeing the results from hundreds of research studies on headache.

These results are put in poster form and then displayed for everyone to see in a separate hall.

Yours truly (ahem!) was proud to present a poster on the benefits of IV Keppra in treating migraine..

Two new systems were introduced through posters that would allow someone to take sumatriptan either trans-dermal or a new injectable that is needle-less! A statement was released today by the company making Sumaptriptan DosePro.

Sumatriptan DosePro provides the most widely prescribed migraine medication in the U.S., sumatriptan, in a novel needle-free delivery system that allows the drug to reach peak blood levels in approximately twelve minutes and takes only three simple steps to deliver,” said Stephen Farr, Ph.D.

The link is to their website. The transdermal system is still in clinical trials but looks very promising. See? There is new information on headaches coming out every few months..so don't give up.

Jun 30, 2008, Occipital Stimulation For Headaches

Occipital stimulation or stim is showing promise as a new treatment for migraine and cluster headaches.

Jun 24, 2008, Migraine Specialists Meet in Boston

The annual scientific meeting of the American Headache Society is this week in Boston, MA. I will be not only attending the meeting but also presenting research on headaches that we did at Dent Headache Center.

This research involved using IV Keppra to break a migraine and it was quite sucessful. I am looking forward to meeting medical directors from two large pharmaceutical companies who are interested in funding migraine research.

By doing research and having you the patient who is willing to participate, we all do our part in finding the cause of migraine and coming up with new treatments.

The meeting will discuss a variety of subjects including electric stim for headache and pediatric issues.

I will report back next week on the results!

Jun 20, 2008, Update on Magnesium

Some research in the last year is indicating that higher doses (600-800mg/day) of magnesium may be effective in blunting two types of migraine: barometric pressure and menstrual migraine.

How does this happen? Well some of the research is indicating that when estrogen levels are low in migraineurs, so are magnesium levels. One study showed that taking magnesium every day for two weeks before menses can prevent this type of migraine.

Although we still don't know the mechanism of barometric pressure migraine, it is worthwhile to consider magnesium if you have these headaches. You must be on the therapy for 90 days before you can fully assess this as it takes that long for the brain to figure out what is going on! Just remember to balance this out with daily calcium!

Jun 19, 2008, Headache Adviser.com Blog

The blog is gaining more and more attention! I have had some really great feedback from patients and other readers who feel the information is worthwhile.

Keep cool in the hot weather and remember to stay hydrated to avoid a headache. Technorati Profile

Jun 16, 2008, Temporal Arteritis

Temporal arteritis, giant cell arteritits and cranial arteritis are all names for the same type of bilateral headache.

Jun 7, 2008, National Headache Awareness Week

Just found this video on Youtube for National Headache Awareness week. If you know someone who isn't tooooo aware of what you are going through..refer them to this link.

The video does a pretty good job of explaining migraines and even features a patient.

Jun 2, 2008, Headache As A Disease

One of the countrys formost headache specialists is Dr. Richard Lipton. He is the director of the Montefiore Hospital Headache Center and recently published this article on Headache as a disease.

The article makes the arguement that headaches are not just a symptom of something else that is wrong. The burden on society due to lost days of productivity because of headache is startling!

Take a quick review of the article and see if you agree with some of the things he says. Then next time someone says "Oh..well you only have headaches." be prepared to respond!

May 30, 2008, Chronic Daily Headaches and Steriods

Many times I see patients with chronic daily headache who have failed on many drugs and are taking daily anti-inflamatories (Excedrin etc) to keep the headache "livable". I had one such lady yesterday who is taking Imitrex tablets daily! (Not from me!) Another lady was taking Naprosyn, Celebrex and Fiorcet.

My response to this is serial steriod infusions. I had them both come in three days in a row and then be on a steriod for two to three weeks.

One lady has responded great so far. The other is in the middle of infusions. This treatment has worked very well before and is just short of admitting the patient.

Speak to your doctor or neurologist. There is usually a chemotherapy infusion center near you for cancer treatment, and this sort of place could do infusions if your doctor orders them.

May 24, 2008, New Research on Namenda for Migraine.

In the last two years or so, those of us in migraine and headache work have noticed that the drug used for Alzheimer's, Namenda, is showing promise in prevention of migraine. Two pilot studies done a few years ago mentioned the need for further research. Of note, this reasearch was on migraineurs who had 8-14 migraine days per month and had failed on two other preventative drugs.

Flaws in this study: The dose was varied between 10 mg and 20 mg per day which tends to confuse things when interpreting results. Also, the study only went for 90 days. In the field of neurology, your brain is just barely recognizing a change at this point. Perhaps the study should have gone longer.

None the less, the results do support previous ones and further research is recommended. With any luck, we may soon be recommending Namenda in clinical practice to treat migraine.

May 20, 2008, Imitrex Is Going Generic

The giant brand Imitrex is going generic by the end of this year. The application to the FDA was approved in January for Roxbury Labs in Princeton, NJ to manufacture Imitrex by its generic name of sumatriptan.

They are permitted to make it in the three oral doses available now..25, 50 and 100mg. So what will be the difference? Well cost is the first one. From $10-25 per tablet currently to generic pricing which means the lowest copay AND some could afford to pay cash if they have no insurance. This opens the door for treatment for millions of Americans.

Second difference is the RT technology of the current tablets..it is a burst technology which allows Imitrex to be absorbed at bit faster. They new drug from GSK (Glaxo-Smith-Kline) Treximet will have this technology and be combined with naprosyn.

So what can you do in the meantime? If you have Imitrex available, combine it with two (2)Aleves which is about equal to prescription naprosyn. SAMPLES of Imitrex from your doctor are now gone, but samples of Treximet are available.

Nasal spray is not sampled but the 4mg injectable is still available and according to the company will continued to be supported through sampling.

Remember..treat early to get rid of migraine.

May 16, 2008, Emergency Headaches

Causes of emergency headaches. Know when and if to get to the doctor for the worse emergency headache of my life.

May 12, 2008, Topamax and Child Migraine

Many times when I see teens and children, the parents are very worried about their headaches, loss of time from school and other activities. However, when the subject of medication is brought up I hear "Not my child!".

While there is every reason to be concerned about medications given to adults being given to your child, the good news is that research is now turning to child migraine. A review of studies of Topamax in children's headaches had good results in reducing pain and restoring activity levels.

May 5, 2008, Migraine Aura

Migraine aura can vary from blurry vision to buzzing in the ears. Read about atypical auras and occular migraine.

May 4, 2008, A Headache During Labor and Delivery

Cases like this always present at 4pm Friday..a 38 year old female delivered twins last week and had a horrible headache immediately afterward. Thinking it was from the epidural, the OB treated it as such, but the headache improved for only 60 minutes then got much worse.

After this, my doctor was called in to look at her and immediately ordered an MRI of the brain and another test to look at the veins in the brain.

Pregnancy is a hypercoagulable state (huh?). It means that the blood naturally thickens during this time, so Mom is at risk for clots. This mother had one that clotted in a vein in the brain causing a mild venous stroke.

Fortunately, a venous bleed is not as damaging as an arterial one. She suffered no physical problems except a severe unrelenting headache. Since she had a past history of migraine, the other doctors assumed that was what she was having.

She will do well with pain medication until the blood reabsorbs, then we will treat the migraines.

May 2, 2008, Migraine Headache Diary

Migraine headache diary is a great way to track your headaches and learn the migraine triggers. Get a free one here!

Apr 27, 2008, Headache During Sex

A headache during sex is embarassing and not normal. Sex headaches can be treated effectively!

Apr 20, 2008, Privacy Policy

Privacy policy for www.headache-adviser.com

Apr 20, 2008, Update on Treximet- New Migraine Medicine

After a couple of years of being in and out of the FDA, a new migraine medication Treximet has been approved for launch by Glaxo-Smith-Kline Pharmacueticals.

So what is Treximet? Imitrex combined with naprosyn (prescription level Aleve). Studies done several years ago by several headache centers demonstrated that the combination of both drugs was better in getting rid of a headache FASTER than either one alone!

You can expect Treximet to hit the shelves by early summer 2008. If you currently are taking Imitrex and can tolerate Naprosyn, combine it with the Imitrex at the ONSET of the headache. Take them both together, not one after the other and waiting awhile...good luck!

Apr 13, 2008, Migraine Vertigo

Migraine vertigo can be more disabling than the headache.

Apr 10, 2008, Dehydration and Headache

As the summer months are approaching, remember that one of the triggers for headache and migraines is dehydration. This is especially important regarding children who have headaches, as they can become dehydrated so quickly.

Try to pre-hydrate before exercising and remember to drink water throughout the day. If you are not too nauseated at the onset of a headache, one or two glasses of water can go a long way (with medication) in stopping the headache faster.

Good luck and keep the water bottle handy!

Apr 4, 2008, To Topamax Or Not To Topamax?

In reading some other blogs across the net concerning migraines, I came across the startling statement that: Topamax is a powerful drug and is not the best drug for you to use first to treat your migraines.

Well nothing could be further from the truth. Since when did being powerful become a bad thing? That has absolutely no correlation with side effects which is what I think this author was driving at.

Topamax is one of our first line drug for migraines in our clinic if you have one disabling migraine per month or 2-3 headaches per week. It has a great effect of dampening headaches over a few months and definitely should be considered if you are a candidate for it.

Try not to be frightened by package insert information, stuff on the net (except this website of course!!), and things you hear from other patients. After all, for those people to whom this is a miracle drug..well they are too busy living active headache free lives to get on the net and write about the drug.

Once again..common sense rules.

Mar 31, 2008, NY Times Migraine Blog

Two months ago the NY Times started an online blog for migraine and so far it seems to be gaining alot of attention.

This is a good example of how prevalent migraine is and how much attention is now being paid to this disease. There are also resources listed, many of which are also are found here.

If you are interested, there is slideshow on migraine artthat is quite good.

This particular blog is good as it is comprised of several people, not just one person. The bloggers are professional writers, some medical, some not, but they all have one thing in common: they all get migraines too!

Mar 25, 2008, Children and Headaches

As awareness increases about migraine, more and more parents are bringing their children and teens to our clinic. Many times a patient will ask me about their child when they are in for a routine office visit.

Children can have headaches but this does not mean it's "normal". They may be called abdominal migraines. Children should not have headaches..period.

A new onset of headaches can be worrisome so it is best to discuss it with your pediatrician. But trust your instincts!! You are the parent so if your child is having headaches routinely, don't get brushed off with "take some Tylenol". Ask to see a specialist or a pediatric neurologist.

In our clinic, we see teens, 12 years and above, and our pediatric neurologist sees those under that age.

Find a specialist near you by reviewing places to find headache specialists.

Mar 19, 2008, eHealth Insurance

Looking for health insurance? Apply to eHealth insurance online! Get your meds paid for.

Mar 19, 2008, Headache Products

Headache products to lighten the life of a headache sufferer, including mugs, T-shirts, books and pillows

Mar 15, 2008, Update in Headache Research

The February 2008 issue of Neurology had a new study about the impact of comorbid conditions in headache patients.

83% (!) of migraineurs and 79% of other headache patients were found to have some other form of disability.

The following were significantly increased: mental disorders (depression, anxiety, bipolar disorder), other pain conditions (neck and back pain), and other diseases (irritable bowel syndrome, mitral valve prolapse, ulcers, asthma and hypertension). Other studies have found coomorbidity with epilepsy.

So now what? Well it is important to treat the whole person and address all problems. Many people have noticed, for example that when migraines and anxiety come under control, their irritable bowel syndrome improves! Keep an open mind when a doctor or practitioner suggests a treatment that may improve one or more of your conditions.

Mar 11, 2008, Abdominal Migraine and Other Headaches in Children

Abdominal migraine is frequently seen as a headache in children that is a form of migraine.

Mar 10, 2008, Migraine Cures

Soooo many times I will have a patient call my office 2 or 3 days after an initial visit and complain that his/her migraines are not cured yet. (!) This is usually after more than 10 years of headaches.

It is important to realize that migraines can't be cured but can be managed. Stability is one or two milder headaches per month and it may take many months to get there. To continually stop and start medications after only a few weeks only muddys the waters so to speak. Give yourself a chance..stay with the recommendations for several months and track the headaches.

Read more about migraine cures and methods.