New guidelines help migraine sufferers

USA Today reports, “Many migraine sufferers could have fewer, less severe headaches if they took preventive medicines, but few eligible patients do, say doctors releasing updated treatment guidelines.”

Stephen Silberstein, a neurologist at Thomas Jefferson University in Philadelphia presented the guidelines at the annual meeting of the American Academy of Neurology in New Orleans and they were published in the journal Neurology.

“The guidelines list seven prescription medicines and one herbal remedy backed by strong evidence, and include many other treatments that might work for some patients.”

“People whose migraines are infrequent or mild may not be able to prevent them with drugs, the guidelines say,” the Los Angeles Times “Booster Shots” blog reports.

“But for those who can, the best seizure drugs are divalproex sodium (Depakote), sodium valproate (Depakote, Depakene, Stavzor) and topiramate (Topamax or Topiragen).”

In addition, “beta-blockers are usually taken to treat high blood pressure, heart arrhythmias and other cardiovascular conditions, though metoprolol (Lopressor or Toprol), propranolol (Inderal) and timolol (Blocadren) can also help with migraines.”

WebMD reports, “Researchers analyzed studies on migraine prevention treatments to determine which are or are not effective.”

The piece quotes Mark W. Green, MD, who “says that anyone who has six or more migraine attacks a month or someone who has fewer migraines that don’t respond to treatments is a potential candidate.”

What’s more, “the new guidelines support the use of the herb butterbur.”

HealthDay reports, “The new guidelines include information from 29 studies published between 1999 and 2009 that describe effective preventive treatments for migraine.”

But, MedPage Today reports “the guidelines did not address the use of Botox or other botulinum toxin-based drugs for migraine because these were covered in a separate AAN review published in 2008.”

The review found that a “half-dozen prescription drugs, including antidepressants, beta-blockers, and triptans, were rated as ‘probably effective’ on the basis of one high-quality or two moderate-quality trials” and “no nonsteroidal anti-inflammatory drugs (NSAIDs) received the highest rating for proof of efficacy.”

Additionally, “other OTC products with probable efficacy included magnesium, riboflavin, histamine SC, and the herbal supplement feverfew (MIG-99).” The piece also lists “probably” or “possibly” ineffective agents.

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