Migraine and You

8/10/2019 Migraine and You

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Migraine and You

An Educational Guide

for Migraine

Headache Sufferers


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Who gets migraine?

About 20%

of women

get migraineat one time

or another in

their life

Migraine Prevalence %

Age (years)

Males

Females

Migraine peaks during the most productive time

30-60 years of age

Migraine is disablingsome miss work, school or activities;

many have reduced productivity during attacks

1 10 20 30 40 50 60 70 80


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How do you know you mighthave migraine?

Usually one-sided

Moderate or severe pain

Throbbing pain

Pain aggravated by routine activity

Nausea or vomiting Aversion to light or sound

If you c hecked 3 or more of the YES boxes, you have several of

the diagnost ic cr i ter ia for mig raine. You shou ld talk to your

doc tor about diagnosing and treat ing your headaches.

Yes NoSymptoms associated with your headaches


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What is migraine?

A clear biological disorder Like asthma, diabetes, or hypertension

A disorder of the central nervous system

Hypersensitive to specific triggers and stimuli Often a family/genetic connection

A disorder of nerve cells in the brain

and the blood vesselssurrounding the outside

of the brain


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Why do I get migraine?

Neurons in the brain areactivated by a mechanism

not well understood

This, in turn, causes a

cascade of secondaryevents leading to:

Release of inflammatory

substances surrounding the

blood vessels of the brain Inflammation of the blood

vessels and the surrounding

tissue on the outside of the brain

Pain pathways are activated


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What type of doctor shouldyou see?

Ask for a specific headacheappointment and get aspecific diagnosis

Primary Care

Neurologis t

Headache

Special ist

Family physician,internal medicinespecialist

Headaches frequent anddifficult to manage or if thereare other medical conditionsto manage simultaneously

May need referralfrom primary care

Headaches not responsiveto routine care; otherexisting medical conditionsmaking treatment plan

complex

Headaches aresevere anddisabling; mayneed referral


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What should I tell my doctor aboutmy migraine attacks?

How long have you had headaches? How frequent?How disabling?

When did they start?

What happens when you have a headache? Describe the pain and other symptoms

Who else in your immediate family gets headaches?

Any type of headache (migraine, tension orsinus)

What might cause you to get a headache

Alcohol, too little sleep, stress, missed meals


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What else will the doctor needto know?

What medicines do you take now andhave you taken in the past?

Include over-the-counter medicines, vitamins,

caffeine, and other medicines

What other medical conditions have

you had?

Head injury, depression, etc.,

weight problems, etc.


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What kinds of treatments will help?

Medications

Acute

Taken when a migraine is

experienced Treats pain and other

symptoms after the attack

has begun

Preventive

Taken on a daily basis

Reduces the frequency

and intensity of attacks


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What kinds of treatments will help?

Behavioral approaches Limit caffeine and other

triggers

Reduce stress

Exercise

Regular sleep

Counseling or

psychotherapy

Biofeedback / relaxation

Eat regularly / dont skip

meals


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Are all migraine medicationsthe same?

Migraine medications canall be different and work

differently in the brain and

on different pathways.

Many patients will needboth an acute treatment AND

a preventive treatment

Acute:

Triptans

Analgesics

Preventives

Antiepileptics

Beta-blockers

Antidepressants (TCAs)


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How do you know which type oftreatment is right for you?

Acute Infrequent

Short duration

Do not impact routine functioning

Preventive Frequent headaches (=2 per month) that cause disability

Recurring headaches that significantly interfere with daily

routines

Overuse of acute medications (

2 times per week) Acute medications are not effective, well tolerated or are

contraindicated

Behavioral

Can always be used


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What can you expect from youracute headache treatment?

Acute medications should work within 2 hours

Improve response if you take medicinesearly Decreased pain, nausea, photophobia and

throbbing

Get instructions from your doctor: When to take rescue medicines

What normal side effects might occur

High pain

No pain

Time


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What can you expect from yourpreventive headache treatment?

Preventive treatments will notcure migraine but CAN:

Reduce frequency of

attacks by 20% to >60%

Reduce severity of attacks

Improve response to

acute therapy

Reduce use of acute

and rescue medications

You need to give these

medications adequate time to

demonstrate benefit ( 2- 3

months to fully evaluate)

# attacks

January 7

February 6

March 4


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Improving treatment success

Be pro-active, seek help

Understand your headaches so that you can

appropriately communicate with your provider

Discuss your goals

Develop realistic expectations

Work closely with your provider and follow

instructions Ask for specific instructions for taking each medication

Understand the side effects of each medication

Take only the medicines and dose prescribed


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Taking care of your headachesWhat else can you do?

Account for yourheadaches

Keep a diary

Record medications

Monitor response

Follow the

treatment plan

Take medications only

as instructed Monitor lifestyle factors:

exercise, diet, and

medications / drugs


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Can lifestyle make a difference?

Lifestyle factors play a significant rolein migraine

Triggers that can be controlled or

recognized: Too much caffeine

Too many over-the-counter medications

Sleep deprivation or change in sleep patterns

Hormone fluctuations

Menstruation

Fasting or low blood sugar

Stress or stress let-down


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Tips for acute and preventivemedication success

Acute Medications Tips More is not always better

Take acute medications specifically as instructed

Limit acute medications to once or twice a week

Take only the dose that was prescribed If medications appear to not work after treating 2

or 3 attacks, call your doctor

Preventive Medication Tips

Take the dose instructedno more no less

Give the medication time to work (2-3 months)

Track your headache patterns a gradual

decrease in attack frequency or severity may be

hard to see


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Tips to recognizing medicationoveruse

Taking acute medicationfor headache becomes part

of an almost daily routine

Should be limited to 1-2 days

per week

Medication appears to

become less effective so we

tend to want to take more of it

Stopping/slowing themedication may result in

worsening of headache


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Why is it important to see yourdoctor regularly?

Other problems can arise-or other illnesses Overuse of medicines

Biological changes in the brain

Migraines can get more difficult to control

Headaches may get worse

More severe

More frequent

D t b f d b i i


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Dont be confused by migrainemyths

Myth: Migraine is all in your head like a psychologicaldisorder

Fact: Migraine is a true biological disorder with clear

genetic links and underlying changes in the brain.

Myth: Nobody understands my headaches

Fact: Approximately one in four households in the US

have at least one migraine sufferer.

Myth: Nothing works to treat my headaches it is

hopeless..

Fact: Actually, there are now very sophisticated

migraine-specific medications and very effective

preventive therapies.


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Where to go for more information

The American Headache SocietyCommittee for Headache Education (ACHE)

19 Mantua Road

Mount Royal, NJ 08061

Phone: 856-423-0043

Fax: 856-423-0082

E-mail: [email protected]

Web: www.achenet.org


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Supported by:

Ortho-McNeil Pharmaceutical, Inc.

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Migraine and You