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Migraine headaches

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of migraine.

Highlights

FDA Warning: Serotonin Syndrome

In 2006, the FDA issued a warning against using triptan drugs and certain types of antidepressant medications at the same time. Combining a triptan with a selective serotonin reuptake inhibitor (SSRI) or selective serotonin norepinephrine reuptake inhibitor (SSRI) can result in serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition caused by excess levels of the brain chemical serotonin.

Migraine and Heart Disease

• Migraine with aura increases the risk for stroke, but new research also suggests that it increases the risk for other types of heart problems. Women who experience migraines with aura have a higher risk for heart attack, angina, and death due to coronary heart disease, according to a 2006 Journal of the American Medical Association ( JAMA ) study of over 27,000 women.
• Studies indicate that people who have a hole in the wall between the two upper chambers of the heart (patent foramen ovale) tend to have severe migraines with aura. Researchers are investigating whether repairing this hole can help stop migraines in people with this heart condition.

Menstrual Migraines

Migraines that occur during menstruation tend to last longer, be more severe, and not have an aura, according to a 2006 review in JAMA . Women are 3 times more likely to have migraines than men. Researchers think that the hormone estrogen plays a role.

Topiramate for Prevention

The anti-seizure drug topiramate (Topamax) may provide long-term relief for migraine sufferers. In recent studies, topiramate helped prevent migraine for up to 14 months. Other studies suggest that topiramate may help reduce migraine severity and frequency in people who experience chronic daily headaches.

Investigational Treatments

A transcranial magnetic stimulation (TMS) device may be able to stop migraines before they occur, according to preliminary research presented at the 2006 American Headache Society meeting. The TMS device is held to the back of the head and emits quick magnetic pulses that stimulate nerve cells in the brain.

• Review Date: 10/2/2006
• Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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