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Survey: Migraine Patients Taking Potentially Addictive Barbiturate,or Opioid Medications Not Approved by FDA as Migraine Treatments

Addiction can lead to hospitalization and drug withdrawal

CHICAGO, May 15, 2007 /PRNewswire/ -- A new survey of hundreds of migraine patients and physicians commissioned by the National Headache Foundation and conducted by Harris Interactive shows that 20 percent of migraine patients are currently taking potentially addictive medications that contain barbiturates or opioids and have not been approved by the U.S. Food and Drug Administration for the relief of migraines.

Migraines affect nearly 30 million Americans, according to the National Headache Foundation.

The survey also shows that patients taking prescription medications not approved by the FDA to treat migraines are more likely to experience drug-related side effects than patients taking prescription medications that have been approved by the FDA as migraine treatments.

"It's important for physicians, especially primary care physicians, who most often treat migraine patients, to be aware that medications containing opioids or barbiturates have the potential to produce drug dependence and addictive behavior, especially with regular use," said Richard B. Lipton, M.D., professor and vice chair of neurology at the Albert Einstein College of Medicine in New York City and director of the Montefiore Headache Center. "FDA-approved medications such as triptans are specifically targeted to treat migraine pain and associated symptoms and have a far better safety profile."

The survey of 502 patients and 201 primary care physicians and neurologists conducted earlier this year found that 53 percent of migraine patients take triptans as the primary prescription medication for their condition, but 20 percent take barbiturates or opioids. Another 27 percent take other medications.

Not All Migraine Treatments Are Equal

Triptans stop a migraine attack after the attack begins by stimulating serotonin, which reduces inflammation and constricts blood vessels, thereby alleviating the symptoms of migraines such as pain, nausea and sensitivity to light and sound.

Although barbiturates and opioids are considered effective for short-term migraine relief, many doctors recommend against prescribing them for long-term use because of the potential for addiction and abuse.

    Physicians responding to the survey said that more of their patients

taking opioids or barbiturates experience drug-related side effects than their

patients taking triptans:

                                    Barbiturates      Opioids         Triptans

    Drowsiness/sleepiness               74 %            84 %             22 %

    Fatigue                             60 %            64 %             13 %

    Confusion                           55 %            70 %             12 %

    Forgetfulness                       52 %            55 %              7 %

    Rebound headaches                   52 %            74 %             24 %

Eighty percent of physicians surveyed said they are "very" or "somewhat" satisfied with the side effects profile of triptans, compared with 17 percent who said the same about opioids and 12 percent who said the same about barbiturates.

The survey found that patients taking triptans are significantly more likely than those taking barbiturates or opioids to report that their medication works well at relieving migraine symptoms, with sixty percent of triptan patients reporting that it describes their medication "extremely" or "very" well to say it relieves their migraines symptoms completely compared with 42 percent of patients taking barbiturates and opioids.

Four out of five patients (82%) have taken more than one prescription medication for their migraines, the survey found. The average number of medications a patient has taken to treat migraines is four.

Patients taking opioids and barbiturates for their migraines also reported a lower quality of life than patients taking triptans, according to the survey. Patients taking these drugs were twice as likely as patients on triptans to say that migraines "always" limited their ability to exercise or play sports (35% vs. 14%), engage in sexual activity (33% vs. 17%), drive a car (28% vs. 14%), spend time with family and friends (28% vs. 8%) or simply get out of the house (33% vs. 15%).

Addiction can lead to hospitalization

Cathy Turley, of Rye Brook, NY, who was not involved in the survey, said that in the process of trying to relieve her "debilitating" migraines, which caused her to miss two to three days of work a week, she had become addicted to a medication that contained a barbiturate.

"I was up to 10 or 12 of those [pills] a day," Turley said. "I would take as many as I could as long as I had the headache. That was why I got up to so many pills. It was absolutely the wrong medication for me to take, because it was making the migraine worse."

After spending five days in the hospital to get weaned off the barbiturate, Turley was prescribed a medication specifically approved to treat migraines. The medication has "given me back my life," she said.

Physicians say that detoxification from barbiturate and opioid over-use in headache patients may require hospitalization. (1)

Migraine Patients Want FDA-Approved, Non-Addictive Treatments

Though many patients are prescribed barbiturates and opioids for their migraines, the majority indicated that they prefer their migraine medication to be FDA approved for the disease, not addictive and have few side effects. Seven out of ten patients (72%) surveyed said it's "extremely" or "very" important that their prescription medications not be addictive, and eight out of ten patients (79%) said it's "extremely" or "very" important that their prescription medication have only minor side effects. Sixty-five percent said it's important that their migraine medication be approved b y the FDA to treat the disease.

Some migraine patients mistakenly think their medication is not addictive: 36 percent of patients taking barbiturates or opioids as their primary migraine prescription medication said the phrase "not addictive" describes their medication "extremely" or "very" well, according to the survey.

Few physicians surveyed prescribe barbiturates or opioids (2% and 1% respectively) as a first-line acute treatment for migraines, but general practitioners are more likely than neurologists to prescribe opioids as a second-line treatment, the survey found. Twenty-five percent of general practitioners say they would prescribe opioids as a second-line therapy for migraines, compared with just 7 percent of neurologists.

"Though it's encouraging that the survey showed 53 percent of migraine patients are now on triptans, an approved drug class, the fact that 20 percent of patients continue to take medications unapproved to treat migraine indicates that additional physician education could be helpful" said Suzanne Simons, executive director of the National Headache Foundation.

Simple Steps to Achieving Optimal Migraine Treatment

While there is no cure for migraines, taking the right medication below to effectively treat your migraine will minimize how they affect your daily life. Here are a few steps you can take to help optimize your migraine treatment.

    -- Observe. Make note of any side effects that you experience from your

       migraine medication which may affect your daily activities.

    -- Communicate. Keep a headache journal or diary. The journal may include

       when the headache occurred, its severity, duration, location and

       whether the medication you took to treat it was effective. You can

       download a free headache diary at

    -- Use self-management techniques -- There are ways to manage your

       migraines so that they cause less of a disabling effect in your life.

       Be aware of what can trigger a migraine and try to avoid foods and

       beverages that do so. Some patients can get migraine relief through

       non-pharmacologic treatment such as relaxation training and

       biofeedback. Acupuncture and hypnosis may also be worth trying.

About Migraine

Nearly 30 million Americans suffer from migraine, with women being affected three times more often than men, according to the National Headache Foundation. Migraine is most commonly experienced between the ages of 15 and 55, and 70 to 80 percent of sufferers have a family history of this disease. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.

About the Survey

This survey was conducted online within the United States by Harris Interactive on behalf of the National Headache Foundation between January 16 and 31, 2007 among 502 migraine patients (aged 18 and over), including 244 migraine patients taking triptans as their primary migraine medication, 115 migraine patients taking barbiturates or opioids as their primary migraine medication and 143 migraine patients taking other medications as their primary migraine medication and 201 physicians, including 101 neurologists and 100 primary care physicians survey and who have practiced in the US for at least two years, have treated two or more migraine patients per month, and have written two or more prescriptions per month for migraine. Physician data were weighted by gender, years in practice and region so as to be representative of physicians in the AMA master file. Patient data were weighted by age, sex, race/ethnicity, education, region and household income where necessary to bring them into line with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents' propensity to be online.

The overall results would have a sampling error of +/- 4.4 percentage points. With a pure probability sample of 201 one could say with a ninety-five percent probability that the overall results would have a sampling error of +/- 6.9 percentage points. Sampling error for data based on sub-samples would be higher and would vary.

The survey was funded through an unrestricted grant from GlaxoSmithKline.

About The National Headache Foundation

The National Headache Foundation, founded in 1970, is a nonprofit organization that exists to enhance the healthcare of headache sufferers. It is a source of help to sufferers' families, physicians who treat headache sufferers, allied healthcare professionals and to the public. The NHF accomplishes its mission by providing educational and informational resources, supporting headache research and advocating for the understanding of headache as a legitimate neurobiological disease. For more information on headache causes and treatments, visit or call 1-888-NHF-5552 (M-F, 9 a.m. to 5 p.m. CT).

(1) Young, William B. "Medication Overuse Headache." Current Treatment

Options in Neurology 2001; 3 (181-188).

CONTACT: Suzanne E. Simons, Executive Director of The National HeadacheFoundation, +1-312-274-2651, ; or Rebekah Sinzheimerof GCI Group, +1-312-229-8731, , for The NationalHeadache Foundation

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