New guidelines for drugs to prevent migraine headaches

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.

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