The Difference Between Drugs

Have you ever been to the doctors office and been totally thrown when they start talking about preventative, abortive and rescue drugs? I have, and I’d like to clear up the confusion.

Now, because I am not a medical expert I consulted Health Central [dot] com. Below is just a brief overview of the article by migraine expert Teri Robert. The article is very in depth, and really breaks down the different medications in each category. Plus they have information about several of the different medications.

PREVENTATIVE:

These are medications that are taken daily to prevent a migraine…hence the name. These are more for people who get migraines fairly frequently — like weekly.

ABORTIVE:

Abortive medication attacks a migraine already in process. “They work to reverse the dilation of blood vessels and inflammation of the surrounding nerves and tissue,” according to the article by Robert.

RESCUE:

Rescue medications are the last resort in migraine treatment. They are basically pain medications, which are used when the abortive drugs either don’t work or when the patient can’t take them. While they don’t get rid of the migraine, rescue drugs conceal the pain as the migraine works itself out.

“Which medication are part of your regimen depends on you and your Migraines,” writes Robert. “Migraineurs with infrequent mild to moderate Migraine[s] may do fine with abortive medications only.”

It seems the best way to finding the remedy that works for you is knowing your condition. If your family doctor isn’t fully meeting your needs, go see a migraine specialist! Go back and look at my Migriane Center map. Or search the web and find a migraine specialist near you.

 

Interview with a Pharmacist

The other day I spoke with Mark Shaw, a pharmacist at my local CVS Pharmacy. I wanted to figure out how much people could rely on over the counter medications from an average drug store. And how doctors come to the diagnosis of a migraine condition.

Q: What kind of relief can over the counter medications, like Excedrin Migraine, offer migraine sufferers?

A: Pretty considerable, but it all depends on the serverity of the headache. Cost wise, over the counter meds are very efficient.

Q: Is there a particular prescription drug for migraines that doctors seem to use more than others?

A: It really depends on the type of headache that a person has. Different medications can do more for cluster headaches, tension headaches, sinus headaches and the like. But, beta blockers have remained popular among doctors.

Q: In your opinion ,which type of migraine medication works better preventative, abortive or rescue?

A: Well, that is very hard for me to tell based on customer’s prescriptions alone. I don’t know if they take them regularly, or any of the details of their medical history. The best are triptans, like Maxalt or Imitrex. They’re diagnostic medications. But, they’re very expensive, almost $20 a pill; and most insurance companies cover only very small prescriptions — like six pills per month. If someone has a migraine every week, it could cost them a bundle out of pocket in the long run.

Q: It seems more people are getting migraines. Has increased publicity made people go and see their doctors about their headaches?

A: That may be. The most difficult thing is diagnosing a migraine condition. If a patient responds to a treatment, like Maxalt or Imitrex, then the problem is most likely a migraine. There was a study of neurologists that found neurologists had more migraines because they knew what they were. It’s all about knowing your condition.

 

Acupuncture and Migraines

I have been really thinking about using acupuncture as a relief for migraines. I think that it’s a very interesting topic, which is funny because I’m terrified of needles.

Below is a video I found on Youtube about acupuncture and migraines. While Youtube is a fun Web site, anything posted is not necessarily correct. I’d suggest doing some research about who is posting the material.

The video is from the user Expert Village. I like this user because I have always been able to back up its claims with other sources. Plus Expert Village has its own Web site as well. Check it out here.

Expert Village [dot] com has a ton of information. All of its videos are professionally produced, and have well researched information. Aside from the migraine videos, I found this one very helpful.

Note: the Web site is sponsored, so expect ads either before or after the video. They also might pop-up at the bottom of the video, but you can close them.

Enjoy the acupuncture video!

 

Alternative Migraine Treatments

Ever since they began, I have always treated my migraines with prescribed medication and over-the-counter drugs (ex. Tylenol and Excedrin Migraine). There is, however, this burgeoning new field of research that explores the effects of alternative treatments on chronic headache disorders.

Three common types of alternative migraine therapies are acupuncture, Botox and biofeedback.  While these are not the only alternative options, they are the most recognized outside of traditional medication.

MAKING A POINT

According to the American Academy of Medical Acupuncture (AAMA), “acupuncture is a method of encouraging the body to promote natural healing and to improve functioning. This is done by inserting needles and applying heat or electrical stimulation at very precise acupuncture points.”

Above is the medical definition of acupuncture. Traditional Chinese teachings say that acupuncture is used to realign all of the different meridians in the body. Thus, acupuncture synchronizes the physical, mental and spiritual.

AAMA states that medical acupuncture may help three aspects of a person’s health. One, it promotes health and well-being. Two, it prevents illness. And three, it treats various medical conditions. The World Health Organization (WHO) has even recognized acupuncture as a treatment for illness, including migraines!

Acupuncturists use very small, thin needles placed in specific areas of the body. These areas were chosen because of the location of nerves.

PARALYSIS OF A MIGRAINE

Botox the number one wrinkle smoother has been gaining in popularity as a treatment for migraines since its side effects were discovered in 2000.  However, skeptics are calling Botox’s effects minimal at best, and very similar to the placebo effect.

Although the number of people who have tried Botox to treat the migraines is small, the results are highly interesting. Here is a video from Health Central. A note to the squeamish, the video shows scenes of injections and a bit of blood.

Vodpod videos no longer available.

According to the  New York Headache Center, Botox injections last for about three months, and many times longer. During the five to ten minute procedure, as many as 20 areas receive an injections. Any discomfort is mild.

The effects of Botox are still being studied and refined by scientists and medical professionals. However, one deterrent remains the same: the cost.

Botox is an expensive treatment. For one treatment, lasting three months, the cost for the drug alone is about $650. Add in the doctor’s fee and a co-pay…it’s most likely between $850 and $1,000.

CONTROLLING THE HUMAN BODY

Biofeedback sounds like something out of “Star Trek,” but it has been used to help control the physiological workings of the human body (ex. blood pressure, heart rate, muscle tension, etc.).

Once thought involuntary actions, biofeedback is a method of continuous observation of the aforementioned functions. The observations are then immediately sent back to the patient, according to the Diamond Headache Clinic.

Through observation that patient can learn how their body reacts to certain foods, activities and environments. If any of these things bring on a migraine and show significant change in body functions, then the patient can successfully avoid potentially harmful situations in the future.

Biofeedback includes using methods like conditioning, feedback instrumentation, behavior modification and adaptation mechanisms, according to the Diamond Headache Clinic.

This migraine treatment method is lengthy and takes patience to master. Some might be put off by the process and the lack of medication as a backup.

 

Migraine Center Map

I’ve complied a group of ten medical centers that focus on the treatment of chronic headache disorders, especially migrianes. A general practictioner is a great source of information and help, but sometimes a specialist is needed to help with the severity of the condition.

Migraine Center Map

 

Migraine drugs show profits

With millions of migraine sufferers in the United States alone, the makers of migraine medications are sure to make a profit. I came across an article in the New York Times yesterday about a new version of the drug dihydroergotamine.

Levadex, made by MAP Pharmaceuticals, is an orally inhaled version of dihydroergotamine. Dihydroergotamine has been used for 50 years as an intraveneous drug to treat headache disorders. It is known to this drug should not be used if you have perhipheral vascular disease (poor circulation), hardening of the arteries (arteriosclerosis), high blood pressue or liver and kidney disease. Pregnant women should not use the drug either as it can cause severe birth defects.

According to the article, Levadex reached all four of its “late-stage clinical study” goals. Levadex also showed improvement of migraine symptoms like nausea, pain and sensitivity to light and sound. While these results are promising, the FDA is asking MAP to host a second clinical trial to confirm the results.

As stated above, Levadex will be available in an inhalable form. Like asthma medications, Levadex will be in an inhaler “except that patients breathe in to receive the drug rather than push the device,” according to the article.

What I found particularly interesting about the article was the financial aspect of the migraine industry. MAP’s stock rose 186 percent after the results of the clinical trial were published. With millions of people seeking relief for their migraines, the profits in the field of migraine medications are large indeed. And with patents on brand medications ending all the time, generic forms of the drugs are big money makers.

 

Web site Review: WebMD

We’ve all seen the commercials for WebMD.com. They’re sometimes poignant, but often leave the viewer scratching his or her head in confusion.

I personally love WebMD, however, the site does have a few critics. Given the economy, and the skyrocketing cost of health insurance, recent articles have been pointing to an increasing trend among people — specifially, recent college graduates — going without health insurance.

Newly minted college grads do not have the money to shop around for health insurance, so they go to the next best (read: cheapest) solution– WebMD. I find WebMD fun because I like to look up the symptoms of exotic diseases when I’m bored, but I digress. However, I do know a few people who regularly diagnose themselves on WebMD, and then rely on over-the-counter products to fix their ailments. These people are probably hypochondriacs in the making, because all they have is the common cold.

Even though the site is monitored and is in good standing with the medical world, WebMD should not replace a doctor. Anybody who thinks it can is in need of proper medical attention.

That being said, I like — and use — WebMD’s migraine section for the following reasons:

One, I like the fact that the information is correct and that I can verify it with the Web site for the World Health Organization.

Two, a note at the bottom of the page reads “WebMD Medical Reference provided in collaboration with the Cleveland Clinic.” I am from the Clevleand area, I know stellar people in the medical industry at the CC, and the reputation of the CC is great. The fact that the CC is consistently rated one of the top hosipitals in the WORLD doesn’t hurt either.

 

Stormy weather…

On May 9, 2009, I posted a slideshow about migraine triggers. In the caption for weather I wrote about keeping track of weather patterns. It’s time for me to take my own advice.

This past week has been rather hellish. Rain comes and goes, the humidity is through the roof and the temperature is hovering between 70 and 75 degrees Fahrenheit. It also doesn’t help that I’ve been taking long afternoon naps. An irregular sleep schedule can also bring on a migraine. The thing is I’m consistently tired, even when I get a full eight hours at night!

I’ve used five of the nine Sumatriptan Succinate Tablets in the past two weeks! Usually the pack of nine lasts me two to three months! I know that this medication does have side-effects that include feeling drowsy, dizzy, tired and sick. I’ve always had those symptoms with my migraines, but nothing to the extent of these past two weeks. I’ve can’t remember when I’ve felt this tired. When school ends I will definately be paying a visit to my doctor.

Because I’ve always used medication to help with my migraines, I have never seriously considered alternative migraine remedies. Being a bit of a cynic, I never put much stock in alternative treatments to any illness. I’d rather take a pill than burn a scented candle — that’s pretty much my motto for most things.

But at the same time, I hate that I have to carry around medication all the time. I’m rubbish at yoga — I’ve always been prone to fidgeting. And the last time a tried deep meditative breathing in public, someone thought I was having respiratory spasm and nearly called the paramedics. Trying to explain that you’re trying to sooth your aura only gets you strange looks, trust me.

According to WebMd.com, clearing clutter is a good way to improve your overall health. I swear I’ve heard this before in relation to migraines. It was probably on Oprah. Is this a sign that I need to clean my room?

 

Blog Review: The Daily Headache

I’ve mentioned in past posts about blogs that I regularly check out. Regarding migraines, I like to read The New York Times migraine blog, which is a very nice collection of anecdotes from people (read: physicians and the odd celebrity) who have to deal with migraines. While I enjoy the NYTimes blog, my favorite migraine blog has to be Kerrie Smyres’ The Daily Headache.

I love that Smyres is not a medical expert, and she specifically points that out in TDH’s about me section. Her advice, she states, should not replace that of a licensed medical doctor. She does have one thing over medical experts, she’s an actual migraine sufferer. Doctors can go on and on about migraines, but unless they actually experience them I’m not interested.

New medicines and research always make an appearance on TDH, and it’s useful information. Although the new info about mirgaine meds and research can contain a little bit of medical jargon, it’s understandable and fair.

There’s also a section devoted to news stories about migraines and the advancement of migraine research. Called News & Notes, the section is a series of links to articles outside of TDH; a lot are from the New York Times.

I like that the topics also include some cheery or fun topics. People with migraines can focus a lot on the doom and gloom of the pain (which, admittedly, does totally suck), but Smyres has had a couple of recent posts dealing with scheduling a migraine day. I don’t really know why this seems “cheery” to me, but I kind of like the idea of scheduling a day to feel like crap…something about it just appeals to me, and is oddly positive.

By not focusing on all things purely scientific, Smyres has created an intelligent, easy to read blog that is informative and fun. I can only hope to build something half-way as good as The Daily Headache.

Cheers,

Elizabeth

 

Medication kerfuffle?

I’ve been reading a lot of migraine blogs recently about the prescription medication Imitrex and it’s generic alternative. I use Imitrex so this is a big deal for me.

I was alarmed to hear that some fellow migraine sufferers feel that the generic form of Imitrex is less effective and costs more. This seems wrong. I just finished my last Imitrex tablet last week, and today when I felt a migraine coming on I took a dose of the generic Imitrex. I did not notice any real difference in effectiveness, but the cost thing still bugs me.

I remember when I first received the generic Imitrex that the price was different. I don’t understand why a pharmacist would give out a more expensive medication, when the one requested was cheaper. Well I understand their reasoning, but I have a bit of a moral problem with those reasons. I’ll need to check my bill again to be sure, but it’s at home which is four hours away.

At first I wondered why I received the generic instead of actual Imitrex. After a few days of mulling it over, I rationalized that my physician most likely checked the box on the prescription that said generic was fine. However, I think that if the non-generic brand was cheaper, the pharmacy should have filled the prescription with real Imitrex.

I really hope that the generic version was cheaper and I just didn’t get ripped off by CVS.

If you were wondering, the generic form of Imitrex that I received was Dr. Reddy’s Sumatriptan Succinate Tablets (100 mg dose).  Like regular Imitrex, side effects include dizziness, feeling drowsy, fatigue and nausea.  The effectiveness for me was equal to that of reglar Imitrex.