Navigation Links
Drugs Can Sometimes Prevent Migraines, but at a Cost

By Barbara Bronson Gray
HealthDay Reporter

MONDAY, April 29 (HealthDay News) -- People with severe or frequent migraines often turn to drugs to prevent them. But do the medications work?

A new review of preventive treatments shows there is not much difference in the effectiveness of commonly prescribed drugs -- they work for some people, in some cases. But there is wide variation in the amount and severity of side effects associated with the drugs.

The researchers found that drugs worked better than inactive placebos in reducing monthly migraine attacks. They prevented half or more migraines in 200 to 400 people per 1,000 treated. But many of the medications had side effects so bothersome that sufferers frequently stopped taking them.

That could be because none of the drugs used to prevent migraines was designed specifically for that purpose, explained Dr. Jason Rosenberg, director of the Johns Hopkins Headache Center. "So, it's not surprising that they don't work all that well. Only one-third get halfway better, according to the study, so a doctor has to treat three people to get one patient better."

Rosenberg, who was not involved with the study, suffers from migraines and thinks many primary care doctors may be less aware of the side effects of the drugs used to prevent migraines than are headache specialists. So, they may not warn patients about the potential problems and frequently don't follow up to see how the patients are doing, he added.

The side effects are typically no fun, said Rosenberg. "A number are badly tolerated. Some cause weight gain, hair loss, can cause birth defects [one drug], some tingling, sleepiness, impaired ability to exercise, an increased risk of diabetes and sexual side effects," he noted. Some problems, such as kidney stones, are only detected with long-term follow-up, he added.

That's why physicians and patients need better information, said review author Dr. Tatyana Shamliyan, a researcher at the Minnesota Evidence-Based Practice Center in Minneapolis. Good research clearly shows potential benefits and harms, and "helps a great deal in making informed decisions," she said.

But finding information about the options and downsides can be difficult.

Rosenberg said that before Shamliyan's study, no one had done a thorough, comprehensive review of the side effects of medications used to prevent migraines. "They've done a Herculean task," he said.

Both the American Academy of Neurology and the American Headache Society have issued guidelines that recommend two types of anti-epileptic drugs and two beta blockers for prevention of migraines in adults. But neither medical group considered the value of balancing the effectiveness against the side effects, Shamliyan said.

Migraines affect about 12 percent of the U.S. population, and involve throbbing or pulsing head pain, often associated with sensitivity to light and sound, according to the U.S. National Library of Medicine.

The new research was published online in the April issue of the Journal of General Internal Medicine. Out of an initial group of more than 5,000 studies related to preventing migraines, the researchers found 215 publications that involved randomized clinical trials -- considered the gold standard in research -- and 76 publications of non-randomized studies. The researchers reported that most trials were funded by industry and did not disclose conflicts of interest by study investigators.

Most of the studies were conducted in the United States and Western countries, and enrolled mostly middle-aged women with episodic migraines. Participants were mostly overweight and had an average of five migraine attacks a month. Shamliyan noted that many of the studies failed to control for key factors, such as the severity of the headaches, the presence of other health conditions in those studied, other migraine treatments being used, family history, and social and economic status.

Based on their analysis of the studies, the researchers concluded that approved drugs and off-label angiotensin-inhibiting drugs (lisinopril, captopril and candesartan), or off-label beta blockers (metoprolol, acebutolol, atenolol and nadolol) were effective in preventing episodic migraines in adults.

Off-label angiotensin-inhibiting drugs showed the most favorable combination of benefits to potential harms. The U.S. Food and Drug Administration permits physicians to prescribe approved medications for purposes other than their intended indications, and that practice is known as off-label use.

The study also found that there's a lack of research available about the long-term effects of drug treatments, especially on quality of life.

In treating migraines, off-label medications are frequently used, said Rosenberg. "In my practice I'm prescribing off-label as much as on-label." This, while state-of-the-art, should be a call to action, he added. "It's totally unacceptable that all the drugs we're using were invented for other diseases."

More information

Learn more about migraines from the U.S. National Library of Medicine.

SOURCES: Tatyana Shamliyan, M.D., M.S., senior research associate, Minnesota Evidence-Based Practice Center, division of health policy and management, University of Minnesota, Minneapolis; Jason Rosenberg, M.D., assistant professor, neurology, and director, Headache Center, Johns Hopkins Medicine, Baltimore; April 2013, Journal of General Internal Medicine, online

Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Pharmacy Robots Linked to Bacterial Contamination of Drugs
2. Penn study cautions use of drugs to block niacin flush
3. Urinary Incontinence Drugs May Be More Trouble Than Theyre Worth
4. Discovery could help to develop drugs for organ transplant and cancer patients
5. Not taking gastroprotective drugs prescribed with anti-inflammatory medicines
6. Live imaging shows response to cancer drugs can be boosted by altering tumor microenvironment
7. Weight-Loss Surgery Beat Drugs for Cutting Diabetes in Very Obese
8. Seniors Stop Taking Heart Drugs In Medicare Donut Hole
9. New Psoriasis Drugs Not Much Better Than Standard Therapy, Study Finds
10. About 1 baby born each hour addicted to opiate drugs in U.S., U-M study shows
11. Blood pressure drugs linked with lower PTSD symptoms
Post Your Comments:
Related Image:
Drugs Can Sometimes Prevent Migraines, but at a Cost
(Date:11/27/2015)... Chicago, IL (PRWEB) , ... November 27, 2015 ... ... some of the largest, most successful and prominent nonprofit healthcare organizations in the ... and governance involvement with various organizations, and helped advance the healthcare industry as ...
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... Avid collector, ... Ann Arbor Michigan boxing style concert posters. This is one of Joplin's most famous ... Canterbury House at the University of Michigan in Ann Arbor. The According to Hawley, ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... located in central Michigan, have come together on Thanksgiving Day to share the ... available for viewing on the Serenity Point YouTube channel, patients displayed what they ...
(Date:11/26/2015)... ... November 26, 2015 , ... CognisantMD ... for diagnostic imaging in the Waterloo region. Using the Ocean Platform, family physicians ... directly from their electronic medical record (EMR) without the need for redundant patient ...
(Date:11/26/2015)... ... November 26, 2015 , ... The Catalent Applied Drug ... need to integrate dose form selection in early phase drug development. The first ... supporting and bringing together the UK’s emerging life sciences companies, corporate partners, and ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , Países Bajos, November 26, 2015 ... la terapia fotodinámica de Bremachlorin para el cáncer avanzado. ... la inmunoterapia con la terapia fotodinámica de Bremachlorin para ... Un nuevo enfoque combina la inmunoterapia con la terapia ... Clinical Cancer Research . --> ...
(Date:11/26/2015)... November 26, 2015 --> ... use SyMRI to find optimal contrast weighting of MRI ... and has signed a research agreement with SyntheticMR in order ... Using SyMRI, it is possible to generate multiple contrast images ... the patient has left, thus making it possible to both ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 /PRNewswire/ ... the addition of the "2016 Future ... Drugs of Abuse Testing Market: Supplier Shares, ... report to their offering. --> ... of the "2016 Future Horizons and ...
Breaking Medicine Technology: