Migraine Year in Review
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H
eadache Medicine is a developing specialty as over the past few years we have participated in re-
search leading to new and ground-break- ing treatments. The reader may be inter- ested to learn about some of the highlights (great and small) of headache medicine published in the headache literature over the past year.
Starting with the most important
headache-treatment advance in the past twenty-five years, the newest medications for migraine prevention have been devel- oped and are effective. Calcitonin Gene- Related Peptide (CGRP)-modulating medications are designed to reduce the inflammation and activation involved in migraine. The medications can be self- injected once or twice per month, or may be administered intravenously every three months in order to reduce the total fre- quency of migraine events. A number of companies have worked on this type of medication, including Alder, Amgen, Lilly, and Teva Pharmaceuticals. The hope is that these non-oral medications will be more effective than current oral medications and possibly replace daily pills, thus improving compliance with treatment. Alternatively, these medications may be used as add-on treatment for
those individuals with
highly resistant migraines who may need more than one therapy for care. The association between migraine and abuse has been recognized. Different types of abuse include emotional, physical, and sexual. A study from the Department of Neurology at the University of Toledo examined the relationship between onset of abuse and migraine. The investigators evaluated data from the National Longitu- dinal Study of Adolescent Health (Add Health), which is a sample of American adolescents (grades 7-12) from 132 schools. Within the total sample, 14% reported migraine, 15% reported depres- sion, and 12% reported anxiety disorder. Looking at just the migraine group, 35% reported depression and 25% reported anxiety disorder, a significantly higher number over the total group numbers. Approximately 61% of migraineurs re- ported abuse compared to 49% of non- migraine sufferers, both populations with surprisingly high frequencies. The final analysis determined that those individuals who reported childhood abuse were 1.7 times more likely of having migraine. Each type of abuse was associated with a higher likelihood of migraine, but the re- lationship to emotional abuse seemed greatest.
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