There’s a new eBook being promoted on Twitter with the migraine hashtag. You can see the so-called cover image of The Prevention and Treatment of Headaches on the right. I say “so-called cover” because what you get for your money is nothing more than a 28-page Microsoft Word document. Don’t get me wrong; Word documents can be great. It just seems to me that if you’re going to sell a document as an eBook, you could at least publish it as a PDF document. Still, that could be overlooked if this eBook contained information of any value.
The format, however, is minor compared to the problems with the content. Here are some of the issues with the content:
- Who is the author? Despite a strong statement about copyright at the beginning of the document, I’ve not been able to find the names of the author or publisher anywhere in the eBook?
- When was it written? Just as I can’t find the names-of the author or publisher, I can’t find a publication or copyright date.
- A migraine is not a headache. The author doesn’t refer to migraine as a headache disorder, which would be correct, but as a headache, which is incorrect.
- Migraine pain level statement. The author says, “the pain is usually extremely intense.” Not so. The pain of a migraine attack can range from mild to severe, OR it can be totally missing from a migraine attack in the case of acephalgic or silent migraine. Many of us with migraine report that pain is not our worst symptom during a migraine attack.
- The vascular theory no longer stands. In discussing the causes of migraine (not triggers), the author states, “Migraines are a type of vascular headache, which means that they are thought to be the result of an abnormality in the system of veins and arteries that provides blood to the brain. Basically, these blood vessels widen more than they should, causing pain.” We now know that is is not true. Migraine is not vascular; it is neurological. Studies have shown that vasodilation does not always occur during a migraine attack, and when it does, it follows cortical spreading depression.** The important thing to know about this is that vascular involvement is not necessary to have a migraine attack or migraine pain**.
- Medications information is poor.
- The author lists several ways triptans work, but fails to recognize that we actually don’t know exactly how triptans work, especially now that the vascular theory no longer stands.
- The author says that triptans are available in oral, injectable, and “nose spray” forms. The orally dissolving tablets, which have been on the market for many years aren’t listed, nor are the FDA-approved iontophoretic sumatriptan patch or the inhaled sumatriptan powder.
- The author lists Midrin with no note that the original brand name was permanently discontinued several years ago or how to find Midrin equivalent medications.
- No mention is made of medication overuse.
- Natural remedies section. Several herbal remedies are listed with instructions to take certain dosages, but no mention is made of potential side effects or consulting your doctor before taking them.
- Section on prevention. The author states, “Triptans, the most popular choice for treating migraines, are often used to prevent migraines.” This isn’t really accurate. Some triptans, particularly naratriptan (Amerge) and forvatriptan (Frova) are sometimes used for a week or so per month to prevention menstrually-triggered migraines, but to say triptans are “often” used for prevention isn’t accurate.
There are also problems in the sections about cluster and tension-type headaches, but it’s not necessary to list more problems given the list above.
I would not recommend this eBook to anyone, even if it were free. Any of the information in it that’s accurate can be found online free of charge, and there’s simply much incorrect and incomplete information in it to recommend to anyone. If Tweets promoting this eBook should carry any hashtags, they should be along the lines of #inaccurate or #spam.
_Reviewed by David Watson, MD. _
Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.