Fourth, her descriptions of preventive, abortive and rescue drugs can be confusing. She classifies triptans as both preventive and abortive medications, depending on how they are used. While it is correct that both Amerge and Frova can be used preventively in certain cases under a doctor's direction, Dr Bernstein's descriptions once again are unclear. Overuse of any triptan, including Amerge or Frova, can lead to MOH. Additionally, Dr Bernstein lists only a small selection of types of preventive medications used: blood pressure, seizure, antidepressants and Botox. There are over one hundred medications in ten different classes used to prevent Migraines. She also dedicates very little space to rescue drugs, vaguely referring to narcotics and the migraine cocktail, without going into any detail.
Lastly, a combination of incorrect facts, typos and sloppy writing makes it difficult for an astute reader to get through the book. Other than those discussed above, her most troublesome inaccuracy is that Migraines can only be triggered by foods consumed in the two hours prior to the Migraine. In fact, it can take 48 hours for food to trigger a Migraine. Dr Bernstein also incorrectly notes that there are 30 million Migraine sufferers in the US (the number is closer to 36 million). Lastly, while typos may not seem like a big enough issue to discuss in a review, it makes me wonder: was this book sped through publication? Were facts correctly cross-checked? If simple typos were left in the manuscript, what else was missed?
Overall, I would not recommend this book to Migraine sufferers. While there is good information presented, Dr Bernstein's writing is too often inconcise and confusing. The same (and better) information can be found in the accurate and clear articles posted here at MMC, as well as Teri Robert's book, Living Well With Migraine Disease and Headaches. I do appreciate Dr Bernstein's intention to write an accessible book about Migraines for the general public, and her emphasis on Migraine as a disease. The inaccuracies and misinformation, however, may lead to misunderstanding. With such a confusing disease, we deserve the clearest information we can get.
Be well,
MJ
Interesting, MJ. I have also been very troubled by the innacuracies in the book, though I have not finished it yet and have been trying to give it the benefit of the doubt. There were numerous points where she downplays dangers. The status migrainous point is one, also right at the beginning in her "myth busting" she states that no one ever died from a migraine attack - well, what of migrainous stroke, then? It is dangerous for a MD and director of a headache center, who will get a great deal of credibility out of her status, to make incorrect points like these.
I do think that her description of the Migraine brain is useful, the phrase she uses is "a high maintenance brain" which I really like. It is helpful for Migraineurs and others to really understand that our brains are different and must be cared for, that our lives must be kept regular to regulate our brains. I also think she has a number of worksheets and tools which are helpful. Now, could those things have been done in a more accurate and well written book? Of course. Is the book worth buying? I don't know. If you're only going to buy one book on managing your life with Migraine, this is definitely not the one. I agree that Teri's book is better!
Megs, thanks for your comments. I agree there are some real positives to the book, including her references to the "Migraine Brain" and "high-maintenance brain". But I am troubled by her use of outdated terms. I didn't mention this in the review, but I think it's very telling that the physicians she consulted with for this book (mentioned in the acknowledgements at the end) aren't any of the names we usually hear about in the research/treatment of Migraine (Lipton, Krusz, Young, etc).
I will be interested to hear your opinion once you've finished the book.
Be well,
MJ