Thursday, September 07, 2006

migraine news roundup 16

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Hold onto your hats - I've got a gripload of links to share this time around.

This article describes research findings that show a link between depression and physical response to psychological stress:

Inflammatory response linked to depression
Study leaders Dr. Andrew Miller and Christine Heim of Emory University School of Medicine say the findings suggest that increased inflammatory responses to stress in depressed patients may be a link between depression and other diseases, including heart disease, as well as contributing to depression itself.

A nice article about migraine disease featuring an interview with two leading doctors in the field:

Interview: The misery of migraines
Q. What is the most promising future area of research?

A. (Krusz) The next generation of aborted migraine agents will be CGRP inhibitors, which stands for calcium gene-related peptides. That critter has to do with part of the migraine's pain cascade. The next generation of triptans ... in three or four years ... will be CGRPs.

The LA Times recently published the following piece on treatment-resistant depression:

In Treating Depression, Persistence Can Pay Off
Researchers find that in some cases a fourth drug regimen can succeed where others failed.
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Some patients who have failed three courses of drug treatment for depression may still derive benefit from a fourth set of drugs, according to the largest study of treatment-resistant depression, the Sequenced Treatment Alternatives to Relieve Depression or STAR*D trial.

A total of 4,041 depressed patients were originally enrolled in the study to test the most effective treatments for their disorder. Those who failed to improve with the initial drug, citalopram, were given a second course of different drugs, then a third. Each course of drugs benefited additional patients.

The study indicates that "the patient who has not responded to two or three previous treatments still has hope for a remission from his or her depression," said the journal's editor, Dr. Robert Freedman of the University of Colorado Health Sciences Center in Denver.

For patients who failed all four courses of treatment, the team said, physicians may have to consider alternative treatments such as electroconvulsive therapy or vagus nerve stimulation.

Although I do not believe it is possible to *cure* migraine, as it is a neurologically-based disease with no known cure, acupuncture is one of many things that may help us more successfully manage the disease:

Can acupuncture cure my migraine?

Not wanting to become reliant on too many drugs however, I decided to explore other ways of alleviating my migraine.

My mother recommended acupuncture, and I must admit that I was at first sceptical.

She had seen a TV programme which seemed to show a link between acupuncture and migraine relief, and she offered to pay for a course of treatments for me to see if it worked.

It would be so cool to have a different option for DHE treatment. Migranal nasal spray has been a real help to me, but the awful taste is not great on top of migraine-related nausea.

MAP Pharmaceuticals Initiates Phase 2 Clinical Trial in Patients With Migraine
MAP Pharmaceuticals announced today the initiation and first patient dosing of a Phase 2 clinical trial evaluating MAP0004 for the treatment of acute migraine headaches. MAP0004 is a novel inhaled drug formulation of dihydroergotamine mesylate (DHE) administered with MAP's patented Tempo(TM) Inhaler. The therapy is intended to offer fast onset of action similar to an IV infusion, but without the need for an injection in a hospital or doctor's office setting.

The Phase 2 clinical trial will be conducted in up to ten sites in the United States as a randomized, double-blind, placebo-controlled study in approximately 100 migraine patients. The efficacy of three doses of MAP0004 will be assessed, with the primary endpoint for the trial being pain relief at 2 hours. Additional endpoints include relief from nausea, phonophobia and photophobia. Safety evaluations will be made throughout the clinical trial period.

The changing air pressure associated with hurricane season seems to bring on more attacks for migraineurs:

Migraine headaches: Under pressure
Often mistaken for sinus headaches, 28 million Americans suffer with the variety of symptoms triggered by migraine headaches.
Hurricane season means something more to Dr. Robert Vollbracht than concerns about storm damage. Vollbracht, a neurologist, specializes in treating people suffering from headaches.

"I was almost overwhelmed by the number of patients who reported worsening symptoms brought on by the hurricane fronts" the past two seasons, he said.

Researchers are closer to establishing a genetic component of depression:

Hopkins-led study finds that chronic form of depression runs in families
Findings validate search for possible genetic link
The odds are more than two to one that people whose close relatives developed chronic severe unipolar depression when they were young will have it, too, according to results of a multicenter analysis of more than 600 people and their families.

Results of the study, published in the September issue of the American Journal of Psychiatry, with Johns Hopkins psychiatrist James B. Potash, M.D., as senior author, show that siblings, parents or children of people diagnosed with chronic major depression before the age of 31 have a 2.52-to-1 chance of also having the disorder. Moreover, first-degree relatives of patients diagnosed with chronic major depression before the age of 13 have a 6.17-to-1 chance of having it. "This chronic form of major depression can be uniquely disabling because of its persistence. Our finding that this aspect of the illness runs in families suggests the value of searching for contributory genes," Potash says, although he cautions that the results also could point to environmental factors, such as loss of a parent at an early age or physical and sexual abuse.

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