Migraine
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Migraine Community MyMigraineConnection New Info on MyMigraineConnection NHF Survey – Migraine-Specific Medications vs. Nonspecific Medications...|
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MMC Lead Expert Supreme Guru  |
 An online survey of Migraineurs and physicians commissioned by the National Headache Foundation and conducted by Harris Interactive shows that 20 percent of Migraine patients are currently taking “potentially addictive medications that contain barbiturates or opioids and have not been approved by the U.S. Food and Drug Administration for the relief of Migraines.”The issue isn't actually FDA approval, but Migraine-specific medications... Read NHF Survey – Migraine-Specific Medications vs. Nonspecific Medications for Acute Treatment.  Teri Robert Lead Expert, MyMigraineConnection terimmc@helpforheadaches.com
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Maven |
So, after reading this article, my question is are opiates and barbituates NOT anti-inflammatories?
I don't have any experience with either as a pain reliever, though I have taken vicodin on an EXTREMELY limited basis. Knowing that a triptan plus naproxin just bolsters the triptan's effect, what is it that would make opiates or barbituates an effective pain reliever (not migraine resolver) for some? aloofelf.blogspot.com myspace.com/leelood5e  |
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Maven |
Very information, Nice to know and to be able to pass on to other's!
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MMC Lead Expert Supreme Guru |
No, opiates and barbiturates are NOT anti-inflammatories. They have no anti-inflammatory properties. Opiates are analgesics; they mask pain. Barbiturates are sedatives.
Since you mentioned Vicodin... It's acetaminophen and hydrocodone -- both analgesics. Naproxen IS an anti-inflammatory. Taking it with a triptan doesn't boost pain relief. It reinforces one of the things triptans do -- the reduction of the inflammation of the nerves and tissue surrounding the blood vessels that dilate during a Migraine. Opiates and barbiturates cannot do that. Opiates mask pain for a few hours. Barbiturates produce a sedative effect that helps manage the pain for a few hours. Did all of that make sense? Bottom line is that the survey focused on Migraine specific meds that actually abort the Migraine as opposed to opiods and barbiturates that only mask the pain and have some sedative effect.
Teri Robert Lead Expert, MyMigraineConnection terimmc@helpforheadaches.com
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Maven |
I guess the findings of this study really don't surprise me. It seems commonsense that patients using barbituates and opiods are going to be less satisfied with their treatment--they're usually the ones with the more serious and difficult to treat migraines. In my case, barbituates and opiods weren't prescribed until all but one (never tried) of the Triptans and also Midrin failed on me. I was then given Fioricet. When I'm really in pain and begging for mercy, they give me Vicodin. Given my circumstances, yeah, I'm unhappy with my treatment options, and I would definitely prefer a Triptan with fewer side effects to potentially addictive meds, but when that fails, I need the non-specific treatments. I hope doctors will still continue to prescribe them for more severe cases (I think they will). It would have been interesting for this survey to find out how many of the 20% using barbituates and opiods had exhausted all other measures first (rather than being prescribed them as a first-line treatment).
I do support the conclusions of this study/article that non-addictive migraine-specific meds should be prescribed first. It's definitely in the interests of the patient to have a med that will actually abort the migraine attack rather than masking it. It's also in the best interests of the patient to avoid meds that are most likely to cause rebound headaches because that would just be feeding the monster. I'm very glad this article makes a point to mention that there are legitimate reasons to prescribe non-specific migraine meds because Triptans and other abortives don't work for everyone or every migraine! |
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Maven |
Yep, makes sense, thanks. I didn't even know they prescribed opiates and barbituates for migraines. I was not aware of the differences between analgesics and anti-inflammatories. I feel better now that I do know, though. Glad I read the article. aloofelf.blogspot.com myspace.com/leelood5e |
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Novice |
I think the study is correct that narcotics are still used as first-line treatment especially coming from a GP office. When I was first being treated for my head pain I went to my GP. He diagnosed me with TTH and migraine. He did immediately start me on a preventative, but he also sent me home with a script for a narcotic. It was several months later after my continuing complaining that the narcotics were not working as well as I would like that he finally gave me my first triptan. The difference I felt after taking the first dose of a triptan was unbelievable. I felt human again for the first time in a long time.
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MMC Lead Expert Supreme Guru |
YES! You got it. This has frustrated me to no end. When they wrote up the press release about this survey, the way it was written actually caused people to miss these points. If, instead of referring to abortives as "FDA approved," they had said "Migraine specific," I think the reports on the survey would have been better understood.
I think the doctors who know what they're doing and have open minds will prescribe what their patients need, be it triptans, NSAIDs, opioids and barbiturates, or whatever. But that's the key -- doctors who know what they're doing and have open minds. In talking about Migraine specific meds vs. opioids and barbiturates, the survey report didn't say anything we haven't been saying for years. What the survey did was put some statistics to the face of acute Migraine treatment to gathering statistics about the prescribing patterns for the meds and some outcome statistics. My goal with our article was to try to give it all some perspective.
Teri Robert Lead Expert, MyMigraineConnection terimmc@helpforheadaches.com
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MMC Lead Expert Supreme Guru |
Super! You're very welcome. I'm glad the article and our discussion cleared some things up for you. Whoohoo! That really makes me feel productive, Leeloo. I believe very strongly that learning about such issues help us take charge of our health and our disease control. Thanks for a great conversation!
Teri Robert Lead Expert, MyMigraineConnection terimmc@helpforheadaches.com
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MMC Lead Expert Supreme Guru |
 Bingo! This was one of the primary reasons for doing the survey and publicizing the results. I had the same thing happen, but not just with my GP. SEVERAL neurologists I went to prescribed opioids (narcotics) and never even told me triptans existed. This remains a big problem.
Teri Robert Lead Expert, MyMigraineConnection terimmc@helpforheadaches.com
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Maven |
I was really surprised that the report found that only 2% of doctors prescribed barbituates and only 1% of doctors prescribed opiods. That seems really low to me. I wonder who they are (PCP's or neurologists) and how often they prescribe them and to whom. Did the original report discuss any of this? It would be really interesting.
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Newbie |
Thank you kindly, Miss Teri. Made much more sense the way you wrote it up and with your explaining. Much appreciated.
Regards, Ray |
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Maven |
Which means 98% or 99% of doctors aren't prescribing them. I would also like to know if those 1% and 2% of doctors prescribed those meds because triptans didn't work for their patients? Did the study tease that out? My migraine doc says he invented Imitrex and all the triptans and had not made enough from his research. If the FDA decides that only triptans are approved to treat migraine, I guess he'll have met his objective.  http://sparklingwithcrystals.blogspot.com/ basilar-artery migraine, MAV, BPPV, migraine with and without aura, cluster headaches, but no tension headaches! W00t!  |
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Maven |
He invented all the triptans?? Lol. Now that's an ego complex
 .I'm not condemning the doctors who do prescribe them, it just seems like a really low estimate, which is interesting. I wish my doctors would prescribe me a rescue med. I had a bad migraine 2 days ago that did not respond at all to Migranal. I suffered that whole night with just ice packs and ice cream. A few days before that, I had a migraine that was made significantly worse by Imitrex, and I just had to suffer through that too on my own. It just adds to my anxiety. |
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Novice |
Hi All,
I thought the survey was extremely interesting, though I was wondering about the number of drs prescribing pain meds as a first line medication- it seems low to me as well. I think that Triptans, DHE, and other meds should be tried first. Still, in some cases it is necessary to control the pain, and most of my neurologisdts have done so, in combination with other therapies- preventatives and abortives. Were the drs asked simply about prescribing opiods as a first line measure? Or in combination? Just curious. Pain free days, sconesail |
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Migraine Community MyMigraineConnection New Info on MyMigraineConnection NHF Survey – Migraine-Specific Medications vs. Nonspecific Medications...
