New drugs, decades in the mak­ing, are pro­vid­ing re­lief for mi­graines

The Borneo Post - Nature and health - - Front Page - by Sarah Van­der Schaaff

Nancy Baum Lip­sitz re­mem­bers the night the pain be­gan. She’d had a glass of white wine with a friend and went to bed with a ter­ri­ble headache. The next day, she still felt hor­ri­ble, the be­gin­ning of what she called a “rolling tide” of near con­stant mi­graines and lower level headaches. For three years she dealt with the symp­toms. Some­times she got tun­nel vi­sion, or a vis­ual aura, a warn­ing that a big headache was on the way. Those felt like “some­one tak­ing a pick and jab­bing it through my nose and eye,” she said. Then there was the vom­it­ing, numb­ness and sen­si­tiv­ity to light and noise. Her speech slurred. Less se­vere headaches felt like a “hang­over.” She stopped ex­er­cis­ing, so­cial­is­ing and over­see­ing her 15-year-old daugh­ter’s home­work, re­ly­ing in­stead on her daugh­ter to take care of her, bring­ing an ice pack, med­i­ca­tion or what­ever else she needed when a mi­graine at­tacked. “Ev­ery­thing you are as a hu­man be­ing gets stripped away,” Lip­sitz said of what was ul­ti­mately di­ag­nosed as re­frac­tory mi­graine. The one thing she did not give up was her work. As di­rec­tor of anaes­the­si­ol­ogy at Carnegie Hill En­doscopy in New York, she knew pa­tients and staff de­pended on her. “I am not go­ing to let a mi­graine shut me in the bed­room,” she said. She showed up at 6am, no mat­ter the pain. Mi­graine, a type of headache dis­or­der that is dis­tin­guished from ten­sion headaches by its pain, fre­quency, and the nau­sea and sen­si­tiv­i­ties Lip­sitz en­dured, af­fects 10 per­cent of the world pop­u­la­tion and 29.5 mil­lion Amer­i­cans, the ma­jor­ity of them women, of­ten dur­ing the prime years of ca­reer and par­ent­hood. The cost, mea­sured by di­rect health-care ex­penses, lost or poor pro­duc­tiv­ity, and missed fam­ily in­volve­ments, af­fects chil­dren, too. A re­cent study showed in­creased anx­i­ety and de­pres­sion in ado­les­cent chil­dren of par­ents with chronic mi­graine. For years, treat­ment has been lim­ited and pri­mar­ily ad­dressed symp­toms rather than pre­ven­tion. Mi­graine was thought to be “more of a hys­ter­i­cal woman’s dis­ease and not given the re­spect it re­ally de­serves,” said Su­san Broner, Lip­sitz’s neu­rol­o­gist and med­i­cal di­rec­tor of the Headaches Pro­gramme at Weill Cor­nell Medicine/New York-Pres­by­te­rian. Fund­ing for re­search has typ­i­cally been dis­pro­por­tion­ately low com­pared with the dis­ease’s ef­fect. But new treat­ments, decades in the mak­ing, are giv­ing pa­tients more op­tions to man­age what is now un­der­stood to be a com­plex neu­ro­log­i­cal dis­ease. This year, the Food and Drug Ad­min­is­tra­tion ap­proved three drugs meant to pre­vent mi­graines and those, along with less ex­pen­sive and less in­va­sive tech­niques to stim­u­late the body’s re­sponse to pain through neu­rostim­u­la­tion, are giv­ing headache spe­cial­ists and the pa­tients they treat op­ti­mism. “The en­tire field is chang­ing,” said Stephen Sil­ber­stein, di­rec­tor of the Headache Cen­tre at Jef­fer­son Health in Philadel­phia. “There is a rev­o­lu­tion in mi­graine.” – Wash­ing­ton Post

*All ma­te­ri­als are only for your in­for­ma­tion, and should not be con­strued as med­i­cal ad­vice. Where nec­es­sary, ap­pro­pri­ate pro­fes­sion­als should be con­sulted

Mi­graine is a type of headache dis­or­der that is dis­tin­guished from ten­sion headaches by its pain, fre­quency, and the nau­sea and sen­si­tiv­i­ties

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