Medical Disorders
Basic InformationLookupsLatest News
Time to Rethink Suicide Warnings on Labels for Anti-Seizure Meds?Smoggy Air Might Help Spur SinusitisIs It COVID? Early Signs May Differ by Age, GenderChanging Diets Mean More Americans Are Anemic NowHow the Delta Variant Is Changing the U.S. Forecast for COVID-19Regeneron Drug Approved to Help Prevent Severe COVID in Vulnerable After ExposureFull Approval of Pfizer COVID Vaccine Could Come in SeptemberSleep Apnea Doubles Odds for Sudden DeathNYC Becomes First to Require Vaccination Proof for Indoor ActivitiesCOVID Booster Shots to Be Offered to 32 Million BritsNo Sign COVID Raises Odds for Preterm Delivery, StillbirthsA Month Late, U.S. Finally Reaches 70% Vaccination MilestoneAHA News: Dangers of Life-Threatening Second Heart Attack May Be Highest Soon After the FirstAfter Nearly 9 Million Pfizer Shots for U.S. Teens, Serious Side Effects Rare: CDCHow Did the Pandemic Affect Cancer Clinical Trials?New Data Shows the Power of COVID VaccinesTroubling Rise Seen in Both COVID, RSV Cases Among ChildrenTake This Refresher on Skin Safety in Summer SunAll Sunglasses Not Equal When it Comes to Eye ProtectionTeens' Heart Risk From COVID Far Exceeds That of Vaccination: StudyCould COVID-19 Accelerate Alzheimer's Symptoms?New Data Details Dangers of Delta Variant, Even for the VaccinatedCDC Now Says Vaccinated Should Be Tested After COVID Exposure, Even Without SymptomsWhy Strokes Can Affect Women, Men DifferentlyMore Than Half of Americans Plagued by Back, Leg PainPfizer Says 3rd Shot of Vaccine Boosts COVID ProtectionVitamin D May Lower Black Women's Odds for COVID-19Primary Care Doctors Often Miss Heart Failure in Women, Black PatientsBogus Info on Cancer Common Online, and It Can HarmDelta Variant Spreads More Easily, Causing CDC Change on Indoor MaskingSevere COVID for People Under 45: Who's Most at Risk?The Heat Is On: Staying Safe When Temperatures SoarWho's Most Likely to Refuse a COVID Vaccine?Second COVID Shot Safe in Folks Who Had Allergic Reaction to FirstHigh Blood Pressure: Which Drug Works Best for You?Pfizer, Moderna to Expand Vaccine Studies in Young ChildrenFederal, State Moves Begin to Mandate COVID Vaccines for WorkersCan COVID Transmit Easily on Crowded School Buses?Worried About Delta-Linked 'Breakthrough' Infections? Experts Explain the RisksMajor Medical Groups Call for Mandatory COVID Vaccination for Health WorkersU.S. to Stick With International Travel RestrictionsSurvey Finds U.S. Parents Split on COVID Vaccination for Kids Under 12Most Unvaccinated Americans Want to Stay That Way: PollIt's Tick Season: Protect Yourself From Lyme DiseaseHigh-Tech Exoskeletons Improve Bowel Function in People With Spinal Cord Injury'Superbug' Fungus Spreads Among Vulnerable in Two U.S. CitiesVaccinations Start to Climb in States Hit Hard by Delta VariantBiden Says Full Approval for COVID Vaccines Coming SoonPfizer Vaccine Offers 88% Protection Against Delta Variant, But 2 Doses NeededSecret Weapon: Why the 2nd Dose of Pfizer Vaccine Is So Crucial
Questions and AnswersVideosLinksBook Reviews
Related Topics

Men's Health
Women's Health

What Works Best to Ease Migraines?

HealthDay News
by By Amy Norton HealthDay Reporter
Updated: Jun 16th 2021

new article illustration

WEDNESDAY, June 16, 2021 (HealthDay News) -- A new research review offers good news for migraine sufferers: There are more pain-relieving options than ever.

In an analysis of over 100 published studies, researchers found that several drug classes showed good evidence they ease the pain of a migraine-in-progress.

Some of those medications have only become available in the past few years, opening up new options for migraine sufferers who don't get enough relief from old standby drugs.

Experts said the widening field of migraine treatments, which also include nerve-stimulating devices, is encouraging.

"It's great news there are now many effective treatments available," said Dr. Rebecca Burch, a neurologist at Brigham and Women's Hospital in Boston.

For any one patient, she noted, finding the right treatment may take some trial-and-error — so persistence is key.

"Stick with it. Don't give up hope," Burch said. "If the first treatment doesn't work, that doesn't mean nothing will."

Burch co-wrote an editorial that accompanied the research review in the June 15 issue of the Journal of the American Medical Association.

The analysis — which looked at 115 clinical trials and 15 previous evidence reviews — offers a needed update, said lead author Dr. Juliana VanderPluym.

"Over the past three years or so, a number of new migraine therapies have become available," said VanderPluym, an assistant professor of neurology at the Mayo Clinic in Scottsdale, Ariz.

They include the oral medications lasmiditan (Reyvow), which acts on a receptor for the hormone serotonin; and two "gepants" called ubrogepant (Ubrelvy) and rimegepant (Nurtec).

Gepants interfere with CGRP, a small protein released by the trigeminal nerve that plays a key role in generating migraine misery.

The review found, unsurprisingly, strong evidence supporting long-used migraine treatments — namely, nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) and aspirin, and a class of migraine-specific drugs called triptans.

All of those medications beat placebos in reducing pain two hours into a migraine attack, and one day later.

Meanwhile, both lasmiditan and the gepants looked good when it came to reducing or erasing pain two hours into an attack, and one day later. (The strength of the evidence was graded as "moderate" to "high.")

But for the most part, triptans remain the first choice for treating acute migraines, Burch said.

Triptans work by targeting serotonin (in a different way than lasmiditan). They are often effective at dulling pain, but a downside is they constrict blood vessels. That means people at increased risk of heart attack or stroke typically cannot use them.

For some other patients, Burch said, triptans simply do not work, or the side effects — like numbness, dizziness and sleepiness — make them difficult to take.

That's where alternatives come in — though so, too, can the practical issues of cost and insurance coverage.

Both gepants and lasmiditan are expensive, VanderPluym pointed out.

So insurance plans, she said, often require patients to try two triptans, or sometimes more, before they will cover the pricier drugs.

Medications are not the only treatment option, though.

The review found that several nerve-stimulating devices outperformed "sham" devices in easing migraine pain. The gadgets are used at home and employ electric or magnetic pulses to stimulate certain nerves involved in pain signaling.

"Devices are a great option for patients who want to avoid medications, or as an add-on to medication," VanderPluym said.

But both she and Burch pointed to one barrier: cost. Insurance typically does not cover the devices, so patients can face high out-of-pocket expenses.

The review also highlights a medication class that should not be used for migraine pain — opioids.

The drugs, such as OxyContin and Vicodin, carry the risks of dangerous side effects and addiction. And when it comes to migraine pain, they simply do not work, Burch said.

The bottom line, according to VanderPluym, is that the "right" migraine treatment plan varies from person to person — and effectiveness, safety and cost all matter.

For people with longstanding migraines, she noted, this could be a good time to revisit their treatment plan with their doctor. Some might find the newer options are worth a try, VanderPluym said.

The study was funded by the U.S. Agency for Healthcare Research and Quality. VanderPluym has consulted for or received research funds from drugmakers Teva and Amgen.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on migraines.

SOURCES: Juliana VanderPluym, MD, assistant professor, neurology, Mayo Clinic, Scottsdale, Ariz.; Rebecca Burch, MD, neurologist, Brigham and Women's Hospital, and assistant professor, neurology, Harvard Medical School, Boston; Journal of the American Medical Association, June 15, 2021


Amazon Smile


Children and Adult services are available now with no wait time.  

Please contact HBH at 860-548-0101, option 2.


powered by centersite dot net