Five recent studies offer new insights on migraine headaches-- its pathophysiologic underpinnings and various modes of therapy.The five slides that follow summarize the key points of those studies and include links to more details. Among the findings:. Evidence-based recommendations for treatment for acute migraine relief in the ED have emerged.. 2 studies report a migraine preventive effect from an entirely novel mechanism--calcitonin gene-related peptide blockade.. There's a link between mid-life migraine and later life Parkinson Disease and parkinsonian symptoms.. The menopausal transition is associated with an increased frequency of migraines.. The newly FDA-approved Cefaly device can be considered a low risk preventative option for patients with episodic migraineÂ
Recently a systematic review examined the available literature on acute care treatments for migraine for effectiveness and tolerability, graded each medication’s level of available evidence, and gave recommendations regarding its use. Five therapies (4 available in the US) with high to low levels of evidence gained a strong recommendation for use. Prochlorperazine (Compazine) carried the highest level of evidence. Ketorolac (IM or IV) was strongly recommended. Meperidine (Demerol) received a weak recommendation. Subcutaneous sumatriptan was the only triptan medication assessed in this review. Details here.
Co-author of two phase 2 studies, Peter Goadsby, MD, PhD, notes that "migraine remains poorly treated and there are few effective, well-tolerated, approved treatments that prevent attacks from occurring." Regarding initial results of calcitonin gene-related peptide (CGRP) blockade, he comments: “We are seeing a truly generational change with the first mechanism-based preventive treatment for migraine” that "may potentially represent a new era in disease-specific and mechanism-based preventive therapy for migraine.” Details here.
A recent study published in the journal Neurology has found a link between mid-life migraine, especially migraine with aura, and later life Parkinson's disease and parkinsonian symptoms. What's the connection? Details here.
Consistent with the clinical impression that migraine worsens during the menopausal transition, these data show that the risk of high-frequency headache is greater during perimenopause and postmenopause as compared with premenopause. Details here.
Recently FDA-approved for the prevention of episodic migraine, the Cephaly device can be considered a low risk preventative option that may reduce headache frequency in about half of patients.Details here.
