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Category: Chronic Headache

Help for Migraine Headaches

Help for Migraine Headaches

A very recent review of prophylaxis of migraine was published in the Canadian Medical Journal (1). To say the least, their findings were remarkable. Although this was a medically oriented review, several herbal and nutritional approaches were rated as effective as drug therapy with significantly fewer reported adverse events. Table 1 is a summary of the findings of the review for interventions when the outcome measure used was the odds ratio of a 50% decrease in frequency of migraine. All findings were based on studies that were graded by the authors as A or B evidence based on the United States Preventive Services Task Force criteria.

 

 

 

 

Table 1

Intervention Quality of evidence Odds ratio of
50% decrease in frequency
Adverse effects
Divalproex A 2.74 Frequent at higher dosages
Gabapentin B 4.51 Occasional
Topirmate A 2.44 Frequent
Amitriptyline B 2.41 Occasional
Propranolol B 1.94 Infrequent
Riboflavin (400 mg/day) A 5.60 Infrequent
Butterbur (50 mg B.I.D) A 2.24 Infrequent

Pharmaceutical interventions are obviously favored by the medical community even when, at least according to this review, riboflavin and butterbur demonstrate equal or superior effectiveness in A graded studies yet report infrequent adverse effects.

Butterbur: A 2006 systematic review reported on 2 randomized trials (RCT) of butterbur extract (Petasities hybridus) which totaled 293 patients. In these studies a 150 mg dose of butterbur was more effective than a 100 mg dose over a period of 3 to 4 months. Overall butterbur demonstrated a decreased frequency of migraine in over 50% of patients. The brand name of the form of butterbur used in this study was Petadolex (2). In an open label study of 109 children and adolescents the authors found 77% of all patients reported at least a 63% reduction in the frequency of migraine (3). Although no significant adverse effects have been reported in the studies mentioned above, concerns relating to hepatotoxicity have been reported in the literature. A recent study utilizing Petadolex found it to be “free of signals for drug induced liver injury” (3). Several authors have suggested butterbur may be a valuable tool in the prevention of migraine (4-7).

Feverfew: Feverfew is herb that has demonstrated effectiveness in the prevention of migraine in some studies and conflicting results in other studies. Three Cochrane reviews have been published relating to feverfew. The original review could not demonstrate efficacy for feverfew (8) but an update published the same year reported “feverfew is likely to be effective in the prevention of migraine (9). The third review returned to the original position stating “there is insufficient evidence” to suggest an effect (10). A separate article suggested the reason for lack of efficacy reported in the most recent Cochrane review was the 400% variation in the active ingredient in the studies evaluated (5). One RCT published after the Cochrane reviews showed migraine attacks decreased from 4.76 attacks per month to 1.9 when using MIG-99 after 3 months. A dosage of 6.25 mg t.i.d. were used (11). All studies reported a favorable safety profile.

Coenzyme Q10: Coenzyme Q10 has demonstrated efficacy in 1 RCT and several open trial design studies. The RCT was a study of 42 patients. The dosage was 100 mg t.i.d. There was a 50% decrease in headache frequency in 42.6% of the patients in the active treatment group compared to 14.4% in the placebo group after 3 months. The number needed to treat was 3 (12). Another case series found similar benefits using 150mg daily (13). None of the studies on coenzyme Q10 reported adverse effects.

Riboflavin: A RCT compared a combination of riboflavin (400 mg), magnesium (300 mg) and feverfew (100 mg) to 25 mg of riboflavin. Both groups achieved statistically significant improvements over baseline. The authors noted both groups exceeded the normal placebo response reported in other migraine prevention studies. This study suggests a small dose of riboflavin may be an effective prophylaxis for migraine (14). Another RCT using 400 mg daily reported statistically significant improvements in headache frequency and headache days after 3 months. The number needed to treat in this study was 2.3 (15). Unfortunately 2 studies of riboflavin in children did not demonstrate improvement (16;17).

Magnesium: A 2008 RCT examined the prophylactic effect of 600 mg of magnesium citrate daily for 3 months compared to a placebo. Statistically significant improvements in frequency and severity were found in the treatment group. Additionally cortical blood flow increased significantly in the treatment group (18). A second RCT also found a statistically significant decrease in migraine frequency after 3 months using 360/mg per day (19). Not all RCTs have shown magnesium to be of effective. A 1996 RCT found no benefit when using magnesium (20). Soft stools and diarrhea were a common mild adverse event occurring in 18.6% (19) to 47.7% (20) in the magnesium groups.

Several other interventions have limited evidence demonstrating effectiveness. They include ginkgolide B (21), lipoic acid ( 600 mg/day) (22) and fish oil or olive oil (23).

It should be noted that time frame of treatment almost all prevention studies is 3 months. Treatment success or failure should not be assessed prior to completion of 3 months of the intervention.

Article is shared from www.chiroaccess.com

Unhealthy Lifestyle Linked to Headaches in Teens

Unhealthy Lifestyle Linked to Headaches in Teens

Most teens experience headaches at some point and many will suffer the debilitating impact of persistent headaches or migraines. Chronic headaches can prevent teens from engaging fully in school, work, and extracurricular activities. Yet little was known about what triggers headaches in teens until now.

A recent study indicated several lifestyle habits associated with migraine and tension headaches in teens. Researchers asked 1, 260 adolescents to fill out a survey on whether they had headaches and if so, the duration and type of headaches they experienced. Participants also responded to questions about their diet and lifestyle including:  their physical activity, consumption of alcoholic, nonalcoholic, and coffee beverages, eating patterns, and whether they smoked.

Nearly half of the teen surveyed had tension headaches, 10% had migraines, and 20% had a combination of the two.  A considerable amount of participants had unhealthy lifestyle habits like drinking, alcohol and skipping meals. However, 75% had never smoked and 43% didn’t drink coffee.

Researchers found that teens were more likely have migraines if they also drank alcohol, coffee, and/or had low levels of activity. Low physical activity was also associated with tension headaches. Teens that smoked were more likely to have a combination of tension and migraine headaches.

While the study indicates correlation rather than causation, the results do suggest strong links between unhealthy lifestyle and the presence of persistent headaches in adolescents. Researches recommended that further research be done to asses whether educational programs could influence teens’ behavior and experience with headaches. If you’re a teen with persistent headaches or someone you love is, consider consulting with a doctor of chiropractic about healthy lifestyle and nutritional choices that can prevent further pain.

Special Note: One of the best things you can do for headaches is see your chiropractor. Be sure to schedule an appointment with Dr. Oblander if you or your child are having frequent headaches! You can call our office at 406-652-3553.

Fiore, Kristina. “Diet and Lifestyle Linked to Headaches in Teens.” Medpage Today. June 7, 2010. Accessed October 26, 2011. http://www.medpagetoday.com/Neurology/Migraines/20521.

Milde-Busch A, et al “Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study” Headache 2010; DOI: 10.1111/j.1526-4610.2010.01706.x.

Article written by Michael Melton and shared from www.chironexus.net

Chronic Headache Linked to Anxiety, Depression

Chronic Headache Linked to Anxiety, Depression

Tension and cervicogenic headaches are clinically similar, but they are associated with varying personality traits. A recent study evaluated the personality differences between chronic headache sufferers to determine the traits most closely linked to each type of headache.

The researchers administered personality questionnaires to the participants and measured their depressive trends with the Plutchik-van-Praag Depression Inventory. The study involved 26 healthy men, 18 suffering from chronic tension-type headaches, and 19 with cervicogenic headaches.

Compared with healthy participants, those with chronic tension headaches scored significantly higher for Neuroticism-Anxiety and on the PVP depression test. People with a high Neuroticism-Anxiety score are described as tense, worried, fearful, and sensitive to criticism. Meanwhile, the cervicogenic headache group scored significantly lower for Thrill and Adventure Seeking traits. This measurement of sensation-seeking represents the willingness to take risks for excitement, indicating that patients with cervicogenic headaches have less desire to engage in activities involving speed or danger.

These results indicate that higher scores for depression and  neuroticism-anxiety are linked with chronic tension-type headaches, while lower sensation-seeking scores are linked with cervicogenic headaches. However, it has not yet been established whether these abnormal traits are the causes or consequences of headaches.

These findings may encourage the use of psychotherapy for patients with headaches. In addition to undergoing chiropractic treatments, managing anxiety and depression could be an important component of headache relief.

Reference

Chen W, Yu S, et al. Personality Characteristics of Male Sufferers of Chronic Tension-Type and Cervicogenic Headache. Journal of Clinical Neurology 2012; 8(1):69-74.

Shared from the following website: https://www.chironexus.net/2012/09/chronic-headache-linked-to-anexity-depression/

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