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The 6 Most Common Reasons Migraine Treatments Fail

Nancy Harris Bonk
Nancy Harris Bonk
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My first real experience with chronic head pain...

Nancy Harris Bonk

Wednesday, May 27, 2009
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There are over 36 million American Migraineurs suffering day in and day out with Migraine and headache pain. Dr. Lawrence Newman, director of the Headache Institute at the Roosevelt Hospital in New York City, recently discussed some of the reasons he feels Migraine treatments fail and patients aren't getting the relief they need.

 

The first problem is the Wrong Diagnosis. Dr. Newman sees many people go to the doctor as the weather changes when they have runny noses and their head hurts. Barometric pressure changes affect many people with Migraine disease, but when they see their doctor he may think they have allergies or sinus headache. What is truly happening is a Migraine attack in 90% of cases.  See Migraines Often Triggered By Change In the Weather. Another problem is many doctors think Migraine pain is unilateral (one sided) when in fact many times the pain can be bilateral (two sided).  Dr. Newman also said that stressful situations may exacerbate a Migraine, or they even may have Tension-Type Headache. Doctors may see these as another disorder altogether, designating the patient "anxious." In this situation the patient won't get the proper medication. A Migraine specialist is the expert who devotes his entire practice to treating people with Migraines and headaches. Our artice Migraine and Headache Specialists - What's So Special has more information. If you need help finding a Migraine specialist, you can find one in our patient recommeded directory HERE

 

Another problem may be  the Right Diagnosis - Wrong Treatment.  Most people with Migraine try over the counter (OTC) medication such as acetaminophen first. These may not the best choice if Migraineurs have nausea and light sensitivity with their attacks, Dr. Newman said. Many times over-the-counter medications (OTC 's) are not enough, and prescription medication is needed to treat the Migraine. With so many types of medications available, it is difficult to tell the difference between them. Preventive, Abortive, and Rescue Medications - What's the Difference? will clearly explain them.

 

Now that we have the right diagnosis, we may come across the Right Medication - Wrong Dose issue. Dr. Newman suggests that Migraine medications be prescribed at their highest dose for maxium effect. He said starting at the lower dose won't work and should only be started at a lower dose if there are potential side effects. Dr. Stephen Silberstein, director of the Jefferson Headache Center and Professor of Neurology at Thomas Jefferson University, on the other hand, suggests that Topamax, a medication used for Migraine prevention, be started at a low dose and slowly tapered up, saying this is essential for its success. (This is also Dr. Newman's philosophy when it comes to medications such as Topamax, but it is not how it came out in the article written about his views on treatment failure.) An important note, when we start new medications, it may take up to three months to see a reduction in our Migraine frequency and severity.

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This animation shows one of the key causes of pain during a migraine--changes to the blood flow within the brain.

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