Februay 17, 2010
Migraine primerMigraine headaches affect more than three million Canadians and a number of different preventive strategies should be considered, says an article in the current edition of the Canadian Medical Association Journal (CMAJ). The review, written by doctors at the University of Calgary's Faculty of Medicine, is a primer for physicians and outlines various treatments and approaches for migraine headaches.
"Migraine headaches are a common, disabling condition. When migraine headaches become frequent, therapy can be challenging," says the review's first author, Dr. Tamara Pringsheim, who is also a member of the Alberta Children's Hospital Research Institute for Child and Maternal Health.
The CMAJ review says that preventive therapy for migraines remains one of the more difficult aspects of treatment, because while there are valid randomized controlled trials to aid decision-making, no drug is completely effective and most have side effects.
Medications used for migraine can be divided into two broad categories: symptomatic or acute medications to treat individual migraine attacks, or preventive medications used to reduce headache frequency. Symptomatic migraine therapy alone, although helpful for many patients, is not adequate treatment for all.
Patients with frequent migraine attacks may still have pain despite treating symptoms and when symptomatic medications are used too often, they can increase headache frequency and may lead to a headache caused by medication overuse.
"At least 12 percent of the population suffers from migraines and it is important to realize migraines can cause significant disability and result in missed work days, missed family activities and a lot of frustration," says Dr. Werner Becker, a member of the Hotchkiss Brain Institute and senior author on the review.
"Physicians need to educate patients about migraine triggers and lifestyle factors," he says. "Fortunately most patients are able to reduce their migraine frequency if they are willing to work at it with their health-care professional."
Common headache triggers include caffeine withdrawal, alcohol, sunlight, menstruation and changes in barometric pressure. Lifestyle factors such as stress, erratic sleep and work schedules, skipping meals and obesity are associated with increased migraine attacks.