Migraine and the Future of Treatment

Hello there fellow blogettes. This week you are going to be treated to a write up of the EHMTIC (trying saying that when you have a migraine) conference.

We met at a hotel in London. I felt like I was part of a club, as we were all given a bag and some lunch (gluten and dairy free options of course, copious amounts of water, smoothie juice and decaf tea!). This gave us the chance to meet fellow sufferers and we were all swapping stories and advice. I also felt really in awe of the researchers who are so committed to helping us migraineurs. So if you ever feel alone out there because of your illness, remember these researchers who are working every day, all over the world to make things better for us. One of the researchers from California said to us "looking at you lot out there gives me strength!" He wants to help us!

I wrote copious notes, hardly any of which make sense to me now!!! SO here goes:

Migraine and Depression: research indicates that if you have migraine you are at risk of developing depression (apparently the risk increases to 50%). The talk also suggested that anyone with a chronic pain disorder (migraine, arthritis, back pain) would be at risk of developing "depressive symptoms". He also suggested that this is bi-directional ie if you have depression, you are more at risk of developing migraine. The research has not concluded whether there is a common mechanism behind depression and migraine, but recognises that they are both fluctuating disorders of the brain. In his opinion it was considered that the best treatment for people with migraine and depression was the trycyclic anti-depressants (amitryptyline, dosulepin), not SSRI's (prozac).

How your GP should care for your migraine, what NICE says: interesting facts I learnt were as follows:
1. for a bad migraine take a Triptan with an Ibuprofen or paracetamol
2. No evidence for ergotamines and cocodamol (risk of rebound greater)
3. Acupuncture has been recommended, and you can ask your doctor to have it on the NHS
4. a 400mg dose of Riboflavin (B2) is helpful

Migraine and Sleep:
Interesting facts I learnt:
1. A nap has been shown to terminate some migraines (could lead to an argument for employers to supply somewhere to sleep, as this in turn could help the migraineur to stay at work)
2. an imbalance in sleep can lead to headache (lack of restorative sleep)
3. if you do have a sleep problem, there are solutions (melatonin and light therapy) Look out for your local sleep clinic!
4. watch out for premonitory phase (yawning, irritable, craving) particularly late at night as quite often the pain of the migraine develops between 5am and 9am.
5. make sure you are getting 8 hrs minimum sleep a night. Anything less (esp 5 hrs or less) puts you at greater risk of more frequent migraines.
6. Those with migraine have a significant tendency towards circadian extremes (night owl or morning lark)

Future Treatments:

1: drugs being developed at the moment are steering away from affecting your arteries and reducing reccurence of the migraine. Good news for the over 65's who can't take the triptans, and good news for those of us who end of taking so many drugs which then in turn cause us more migraines (rebound migraine)
2: Occipital Nerve Stimulation
3: Magnetic Stimulation

The Researcher predicted that in 4 to 5 years some of this would be widely available and described it as similar to the mobile phone industry. Do you remember those huge "mobile" phones that looked like bricks? Well he said thats where we are with Magnetic and occipital nerve stimulation equipment at the moment, but in a few years time, we may be having small devices that will fit into our bags......

So if your transient receptor potential cation channel isn't working very well, I'll see you next week for Migraine Mum's next instalment. xx