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Migraine & Headache News From the American Academy of Neurology’s Annual Meeting

Migraine-related study findings presented at the American Academy of Neurology’s annual meeting, April 12-19.

Migraine Increases Risk of Severe Skin Sensitivity and Pain
The study found that 68 percent of those who reported almost daily headaches (chronic migraine) and 63 percent of those with episodic migraines reported allodynia, the name of this intensified and unpleasant, painful skin sensitivity. Forty-two percent of people with probable migraine reported the skin pain compared to 37 percent of those with daily or tension headache.

Migraine Frequency Linked with Women’s Risk of Cardiovascular Disease
New research shows women who have weekly migraine are significantly more likely to have a stroke than those with fewer migraines or no migraine at all, but those with lower migraine frequency may face increased risk of heart attacks.

Breastfeeding While Taking Seizure Medicine Does Not Appear to Harm Children
A first of its kind study finds breastfeeding while taking certain seizure medications does not appear to harm a child’s cognitive development.

Children with Migraine at Increased Risk of Sleep Disturbances
Children with migraine are more likely to have sleep disorders, such as sleep apnea and lack of sleep, than children without migraine, according to research on the effects of headaches on children’s sleep patterns.

Overuse of Codeine, Oxycodone and Barbiturates Increases Risk of Chronic Migraine
People who overuse barbiturates and opioids, such as codeine, butalbital, and oxycodone, to treat migraine are at an increased risk of developing chronic migraine.

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Link Between Antiepileptic Drugs and Suicidal Thoughts or Behaviors Distilled

FDA’s warning about suicidal thoughts and behaviors in people taking anti-seizure meds distilled: “For every 1,000 patients, about two more drug-treated patients experienced suicidal thoughts than placebo-takers, FDA concluded,” according to New York Times article FDA Warns of Risks From Epilepsy Drugs. Other article highlights include:

Very rarely were suicidal thoughts or behavior reported. Still, the FDA found drug-treated patients did face about twice the risk: 0.43 percent of drug-treated patients experienced suicidal thoughts or behavior, compared with 0.22 percent of placebo-takers.

The FDA found drug-treated patients were at increased risk no matter their diagnosis, but that the risk was highest for epilepsy sufferers.

If you’re worried about a medication you’re on, don’t stop taking it without talking to your doctor. Stopping anticonvulsants abruptly can cause seizures or other neurological effects.

See Antiepileptic Drugs Linked to Increased Risk of Suicidal Behaviors and Thoughts for the full FDA warning. The 11 medications mentioned:

  • Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
  • Felbamate (marketed as Felbatol)
  • Gabapentin (marketed as Neurontin)
  • Lamotrigine (marketed as Lamictal)
  • Levetiracetam (marketed as Keppra)
  • Oxcarbazepine (marketed as Trileptal)
  • Pregabalin (marketed as Lyrica)
  • Tiagabine (marketed as Gabitril)
  • Topiramate (marketed as Topamax)
  • Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon)
  • Zonisamide (marketed as Zonegran)

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Antiepileptic Drugs Linked to Increased Risk of Suicidal Behaviors and Thoughts

Patients taking antiepileptic drugs had nearly twice the risk of suicidal behavior or thoughts than those taking a placebo, according to FDA analysis. Epilepsy drugs are commonly prescribed for migraine or headache prevention.

FDA informed healthcare professionals that the Agency has analyzed reports of suicidality (suicidal behavior or ideation) from placebo-controlled clinical studies of eleven drugs used to treat epilepsy as well as psychiatric disorders, and other conditions. In the FDA’s analysis, patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%). The increased risk of suicidal behavior and suicidal ideation was observed as early as one week after starting the antiepileptic drug and continued through 24 weeks. The results were generally consistent among the eleven drugs. The relative risk for suicidality was higher in patients with epilepsy compared to patients who were given one of the drugs in the class for psychiatric or other conditions.

Healthcare professionals should closely monitor all patients currently taking or starting any antiepileptic drug for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression.

The drugs included in the analyses include (some of these drugs are also available in generic form):

  • Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
  • Felbamate (marketed as Felbatol)
  • Gabapentin (marketed as Neurontin)
  • Lamotrigine (marketed as Lamictal)
  • Levetiracetam (marketed as Keppra)
  • Oxcarbazepine (marketed as Trileptal)
  • Pregabalin (marketed as Lyrica)
  • Tiagabine (marketed as Gabitril)
  • Topiramate (marketed as Topamax)
  • Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon)
  • Zonisamide (marketed as Zonegran)

Although the 11 drugs listed above were the ones included in the analysis, FDA expects that the increased risk of suicidality is shared by all antiepileptic drugs and anticipates that the class labeling changes will be applied broadly.

I don’t know anything else right now, but will update you when I learn more.

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Epilepsy Drugs (and Headache Preventives) Explained

The Epilepsy Therapy Development Project‘s website has the most comprehensive information on anticonvulsants that I’ve seen. It is thorough and broken down in a clever way, so that you can see the basics or intermediate or advanced information.

Here are links to the site’s descriptions of epilepsy drugs that are frequently used migraine and headache preventives:

Many thanks to Pam for pointing out the site!

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Using Anticonvulsants During Pregnancy May Change Baby’s Head Shape

Mom’s Epilepsy Meds May Alter Infant Head Shape

“Women who use anticonvulsants during pregnancy may increase the risk of delivering an infant with a rare condition called craniostenosis, a study hints.

“The skull consists of five thin, curved, bony plates that meet along lines called sutures. At birth, the bony plates of the skull are not completely joined along the sutures. This allows the baby’s head and brain to grow and develop after birth. After age 2, the sutures begin to close so that the bones can join or fuse together.”

Researchers noted that women who take antidepressants may also have an increased risk for delivering babies with this condition.