Harvard Medical School researchers have found brain changes in patients with migraine. For a more accessible article about the study, read The Migrainous Brain: What You See Is Not All You Get? by Peter Goadsby of the Institute of Neurology. I fear this more than living the rest of my life in pain. It doesn’t necessarily mean changes in brain function, but the possibility is unsettling.
Using two forms of magnetic resonance imaging the researchers studied 24 patients with migraine (12 who had migraine with aura and 12 without aura) and 15 age-matched healthy controls.
There were no differences in cortical thickness in motion-related areas between the participants with migraine who had aura (neurological disturbances such as illusions of flashing lights, zig-zag lines, or blind spots) and those who did not, but the area of cortical thickening in one area corresponded to the source of cortical spreading depression previously identified in a person who had migraine with aura.
As well as showing that there are some structural differences in the brains of people with migraine, the position of the changes could help to explain why some people with migraine have problems with visual processing even in between attacks.
In 2004, Teri Robert of About.com‘s Headache and Migraine section wrote about a study examining the risk of brain lesions in people with migraine. It’s different than the current study, but scary nonetheless.
In case you’re not scared enough: Taking Topamax on a long-term basis increases your risk of developing kidney stones, according to a recent study.
Researchers found that taking topiramate on a long-term basis, or for about one year, caused systemic metabolic acidosis — a buildup of excessive acid in the blood — as a result of the inability of the kidney to excrete acid. Topiramate use also increased the urine pH and lowered urine citrate, an important inhibitor of kidney-stone formation.
“These changes increase the propensity to form calcium phosphate stones,” Dr. Sakhaee said.
In the short-term study, urinary calcium and oxalate — a chemical compound that binds strongly with calcium and is found in most calcium stones — did not significantly change in people taking topiramate.
Kidney stones are solid deposits that form in the kidneys from substances excreted in the urine. When waste materials in urine do not dissolve completely, microscopic particles begin to form and, over time, grow into kidney stones.
Some sort of good news: Sumatriptan, the generic for Imitrex has been approved in Sweden. It will be available as soon as the European patent expires in 2007. Few of you actually live in Sweden, but it could indicate the likelihood of other European countries to follow their lead.
The graphic is from the motor cortex page of PBS‘s Probe the Brain section.
That’s what a press release on a study presented yesterday at the European Headache Federation’s 8th Annual Congress proclaims. Mind you, the study was presented at the “New Reasons for Aspirin in Headache” symposium, which was sponsored by Bayer. And the press release was written by Bayer. Doesn’t exactly inspire confidence in the findings, does it?
The press release caught my attention because I met a new friend yesterday who told me that her life-saving drugs were triptans and aspirin for her migraines and aspirin when her daily headache get bad. She’s the only person I’ve talked to who has had such success with aspirin.
Similarly, With all the drugs I’ve tried, Advil is still my best abortive. Do any of you have a like experience with a basic OTC analgesic?
Just when I was ready to concede that Trexima might provide a migraine treatment better than existing meds, I read the fine print.
The articles say that 57-65% of participants who took Trexima, which combines Imitrex with naproxen (a NSAID, a relative to Advil), reported pain relief after two hours. In comparison, 50-55% of participants who took Imitrex and 28-29% who took a placebo reported relief after two hours. After four hours the percentages rose to 72-78% for Trexima, 61-66% for Imitrex and 37% for the placebo.
The treatment that most accurately compares to Trexima is Imitrex taken simultaneously with naproxen. Why wasn’t this combination studied? My guess is that including this comparison wouldn’t show enough of a difference between the two treatments to justify the FDA approving Trexima as a new drug. Thus, not allowing GSK to continue holding the Imitrex patent.
Anyone who has been diagnosed with migraine without being told about triptans has been done a disservice. In my non-medical opinion, unless a person has an underlying medical condition that would making the medication dangerous, like stroke, uncontrolled diabetes, high blood pressure or heart disease, they should try at least one triptan.
The gold standard migraine abortive, triptans can work like magic for some migraineurs. They don’t work for everyone, but are helpful for many and can abort the migraine entirely before it begins. For others, the effect isn’t miraculous, but the reduction in intensity or severity of their migraines is still significant. It’s also worth noting that a lot of people have to try several different triptans to find the one that works for them.
There are seven different triptans. Imitrex was the first on the market and is the one people are most likely to know about. The others are Amerge, Axert, Frova, Maxalt, Relpax and Zomig. If you can’t keep a pill down, some are available as injections, suppositories and nasal sprays. Remember, though, that even triptans can cause rebound headaches.
To learn more about the drugs and how they work, see WebMD’s terrific article.
Help for Headaches has an in-depth post on Imitrex, including the drug’s history and the benefits of the new 4 mg injection. Teri puts my sparse post to shame!