Earlier this month, Teri and I attended the American Headache Society's Headache Conference in Scottsdale, Arizona. Migraine and headache specialists, neurologists, general practitioners and dentists specializing in TMJ, took part in this educational opportunity. Migraines and headache disorders in children and adults were discussed at length.
Many sessions ran simultaneously, which meant Teri and I had some difficult choices to make. Low pressure headaches, high pressure headaches, Botox demonstrations and post-traumatic headache were just some of them. All were presented by world class Migraine specialists we were eager to learn from.
It was interesting that beta blockers and calcium channel blockers are still first line medications used by most Migraine specialists. Neurostabilizers (antiseizure medications) are not used until later in the treatment regime. Many of our members tell us their doctors start them off on antiseizure medications first - but these doctors are not usually Migraine specialsits.
Dr. Marcie Yonkers and Dr. Paul Winner, both pedicatric Migraine specialists, presented interesting information on treating children with Migraines. It is very clear if a child or adolescent has three or four Migraines a month they need to be treated aggressively. Episodic Migraines can transition into chronic Migraines very quickly in this group. When children come into Dr. Winner's office, he likes to have them pain-free in an hour. Wouldn't that be nice for adults too? Dr. Winner is also pretty clear on some drug choices and children. No depakote for boys, but it is fine to prescribe to girls. He also has children draw pictures of their head pain, which gives him a good idea what he is dealing with.
It was such a thrill to learn from these patient clinicians, some who took time to answer a few questions for me, explaining things to me in a manner I would understand. The conference confirmed the information I know, and expanded the knowlege I need to pass on to you so we can be informed, educated patients. Thanks for reading!
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Dear Nancy:
Thank you for sharing the information from the headache conference. I found some of it surprising (for instance, that non-specialists do not use Beta blockers or Ca blockers before trying antiseizure drugs for prophylaxis). However, even more surprising was that Depakote is not being used in male children, but it is used in female children. Why is that? I thought it was only approved for adults, but assumed that physicians were probably using it for children as well since it is approved for children with seizure disorders.
HOpe you are feeling well.
Clemmie
Hey there! Hope you had a nice Thanksgiving. Ours was just peachy!!
It's not that "non-specialists'' don't use beta blockers and/or calcium channel blockers at all, it just seems they don't use them first anymore. Doctors seem to prescribe the latest and greatest, medications they hear the most about, and patients are aksing for these drugs too. Migraine specialists don't want to reinvent the wheel, but make sure the patient doesn't suffer very long either. "Tried and true first, then move on" - I beileve I heard a few times in AZ. That is what is so great about seeing a Migraine specialsit, they know what works (most of the time) and when to move on.
As far as depakote goes, I'm not sure why he said no to boys, but I do know it is still a good option for adults, male and female alike.
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