New guidelines for drugs to prevent migraine headaches

Published: Tuesday, April 24 2012 2:25 p.m. MDT

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Only a third of those who could prevent their debilitating migraine headaches with medication actually do, despite the availability of several options that may reduce frequency, duration and severity of migraines. Monday, new migraine treatment guidelines were recommended at the annual meeting of the American Academy of Neurology.

The recommendations include some blood pressure, depression and epilepsy drugs that have been shown to effectively help with migraines. The recommendations were issued jointly as an information sheet by the AAN and the American Headache Society.

The guidelines, which will be published later this week in the journal Neurology, are based on a review of 284 studies and publications. The Los Angeles Times Booster Shots blog notes that the review also found an herbal remedy from the butterbur family is effective, too.

The effort was headed by Dr. Stephen D. Silberstein, a neurologist at the Jefferson Headache Center at Thomas Jefferson University in Philadelphia.

Migraine pain and symptoms affect 29.5 million Americans. Migraine is the most common form of disabling headache that sends patients to see their doctors, according to the U.S. Department of Health and Human Service's Office on Women's Health.

According to the Mayo Clinic, "a migraine headache can cause intense throbbing or pulsing in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down. Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots or tingling in your arm or leg."

The experts say not all migraines can be prevented with medication, but those that can seem to respond to the seizure drugs divalproex sodium (Depakote), sodium valproate (Depakote, Depakene, Stavzor) and topiramate (Topamax or Topiragen). Beta blockers includng metoprolol (Loressor or Toprol), propanolol (Inderal) and timolol (Blocadren) can help with migraines.

Among other drugs that "are probably effective and should be considered for migraine prevention," they included the antidepressants amitriptyline (Elavil, Endep or Vanatrip) and venlafaxine (Effexor); beta blockers atenolol (Senormin or Tenormin) and nadolol (Corgard). For menstrual migraines, the list that seems likely to be effective includes naratriptan (Amerge) and zolmitriptan (Zomig). They said frovatriptan (Frova), used to treat migraine, can also prevent menstrual migraines.

EMAIL: lois@desnews.com, Twitter: Loisco

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