Migraine Prevention Drugs Effective But Underused

Migraine prevention drugs could give respite to nearly 40 percent of people who tolerate debilitating headaches, according to new guidelines issued Tuesday by the American Academy of Neurology.

Despite available daily drugs that prevent the onset of migraine symptoms, less than one-third of migraine sufferers take preventative medication, researchers said.

Some migraine patients do not respond to treatments and experience frequent painful headaches that interfere with daily life, yet could benefit from preventative measures, researchers said.

People who have relatively mild migraines that come infrequently and respond well to acute treatments, those people don't need preventive therapy, Dr. Richard Lipton, director of the Montefiore Headache Center, who was not involved in writing the guidelines, told ABC News. But if you're losing more than 10 days per month to your migraines, it's probably worth taking medication on a daily basis.

Migraine patients could reduce the severity and frequency of their symptoms by over 50 percent with daily medication, according to the new guidelines.

Studies show that migraine is under-recognized and undertreated, Dr. Stephen D. Silberstein, a neurologist at the Jefferson Headache Center, who issued the guidelines, said in a statement. About 38 percent of people who suffer from migraine could benefit from preventive treatments.

Many migraine patients give up trying to manage the condition after years taking medications with few success and numerous side effects, Michael John Coleman, founder of the National Migraine Association, who was not involved in writing the guidelines, told USA Today.

You have a lot of gun-shy patients because of a lot of bad experiences, Coleman said.

The new guidelines recommend a combination of anti-seizure and blood pressure medication that together could reduce migraine frequency and severity. The guidelines also recommend over-the-counter medications such as Advil and Aleve and the herbal remedy butterbur.

Although there is no cure for migraine, preventive medications can decrease migraine occurrence by 50 percent or more, as well as reduce the severity and duration of headaches that do occur, Dr. Brian Grosberg, associate professor of clinical neurology at the Albert Einstein College of Medicine, who was not involved in writing the guidelines, told HealthDay.

Over 35 million people in the United States have migraines, according to the Migraine Research Foundation. Migraines are debilitating headaches that often cause nausea, vomiting and sensitivity to light and noise and can last for up to 72 hours. Healthcare costs related to migraines total $17 billion annually in the United States, according to a 2005 study.

The underlying cause of migraines is unknown, but researchers have identified triggers associated with the condition such as stress and hunger. Women who experience migraines are more likely to have an attack around menstruation, and oral contraceptive use can increase the risk, according to a 2010 study.

In addition to preventative medication, health experts recommend migraine patients get enough sleep and avoid foods that trigger migraines such as red wine, monosodium glutamate flavor enhancer and cheese, according to WebMD.

Researchers warned that all drugs have side effects or interact with other medications, so it's important to speak to a doctor before beginning any drug regimen. Despite any potential side effects, people should not hesitate to take medication that could prevent their migraines, Dr. Robert Duarte, director of the Pain Center at the Cushing Neuroscience Institute, who was not involved in writing the guidelines, told WebMD.

Taking preventive migraine medication that has been shown to reduce frequency and intensity of headaches will result in less dysfunction, Duarte said. These benefits often outweigh any risks.

It may take a bit of trial and error to find the right combination of medication and dosage, but 80 percent of people will get relief, Silberstein said.

Migraine is one of the most disabling conditions known to man, he told USA Today. But patients need to know that there is hope.