Sunday, October 01, 2006

migraine news roundup 21

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The FDA has issued a warning about an increased risk of birth defects when women take lamotrigine (brand name Lamictal) during pregnancy. Lamictal is prescribed off-label for migraine prevention.

Glaxo epilepsy drug may cause cleft lip risk
FDA warns mothers who take Lamictal at risk for cleft lip or palate for babies.
Taking GlaxoSmithKline Plc's Lamictal epilepsy drug during the first three months of pregnancy may increase the chances of having a baby with a cleft lip or palate, U.S. regulators warned Friday.

"More research is needed to be sure about this possibly increased chance of cleft lip or cleft palate in babies born to mothers who take Lamictal," the Food and Drug Administration said in an alert posted on its Web site.

Women who are pregnant or thinking of becoming pregnant should not stop taking Lamictal without talking to a doctor, the FDA said.

Who knew identity theft had entered the medical world? How frightening. The Los Angeles Times reports that this growing problem may be worsened by the push for electronic medical records:

ID Theft Infects Medical Records
Victims face bogus bills and risk injury or death. Privacy laws make such fraud hard to pursue.
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Although the most typical of the millions of identity theft cases in the U.S. each year involve credit cards, a 2003 federal report estimated that at least 200,000 instances involved medical identity fraud. Experts believe that the rising cost of healthcare is driving more identity theft, and that many people are unaware they have become victims unless they receive a hospital bill or query from their insurer.

"There's no reason to assume the patients ever find out," said Harvard University management professor Malcolm Sparrow, an expert on regulatory agencies who has written books on healthcare fraud. "The bulk presumably remain invisible."

With their medical records compromised, victims of this kind of fraud face a greater risk of injury or even death if doctors make treatment decisions based on bad information. Files might list incorrect prescriptions or the wrong blood type. Or, as in Weaver's case, an erroneous diagnosis of diabetes.

Researchers have examined the brain's management of emotion and learned that it is more difficult for some people to control the way in which they process stimuli:

How the Brain Controls Emotions
Daily life requires that people cope with distracting emotions--from the basketball player who must make a crucial shot amidst a screaming crowd, to a salesman under pressure delivering an important pitch to a client. Researchers have now discovered that the brain is able to prevent emotions from interfering with mental functioning by having a specific "executive processing" area of the cortex inhibit activity of the emotion-processing region.

The findings also offer insight into how sufferers of post-traumatic stress disorder (PTSD) or depression are unable to control emotional intrusion into their thoughts, said the researchers.

The Washington Post had this great article on depression earlier this week:

Plumbing the Depths Of Depression
Scientists Hope A New Tool Will Tap Into the Source Of the Blues
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It has been documented in various guises -- mania, melancholy, schizophrenia, fatalism, despair, suicide -- since man first took twig to papyrus. It has been regarded as a moral weakness, a sin, evidence of a flawed mind or the required companion to artistic genius. It uses the normal if unhappy thought patterns of sadness, grief, regret, fear and anxiety to scorch the psyche. It has been found in all cultures in all centuries. You think it is alienation, a postmodern creation of the European industrial age, and then you find out that rural Sri Lanka has the world's highest rate of suicide.

The World Health Organization estimates that 121 million people on the planet currently meet the criteria for clinical depression. These are long-lasting loss of energy, patterns of negative thoughts, inability to concentrate, suicidal ideation, insomnia and so on. There is no test, as there is for diabetes or a brain tumor. There is no clear marker separating, say, natural grief and the medical condition.

It's more of a feeling that goes out of control. It's the difference between waiting for the sun to come up, which is sadness, and the knowledge that the sun will never shine again, which is depression.
Genetics plays a part in depression, too, as it clearly runs in families -- but there is no single gene responsible, geneticists say. Exercise alleviates some measures of depression. Light therapy in winter. Reducing stress. Manic depressives -- a different category of illness -- respond more to lithium. Psychotics, the most severe form of mental illness, respond to still other drugs.

"Everyone is aware that we don't treat depression that well," says Peter D. Kramer, author of "Listening to Prozac" and clinical professor of psychiatry and human behavior at Brown University. "Prozac wasn't effective at more major depressions, but only with more minor forms of mood disorder. I think the field is very much waiting for the next breakthrough. We'd like to have a few more arrows in the quiver."

Occipital nerve stimulation is being studied as a treatment for migraine:

New migraine treatment is tested
Researchers at the Rush University Medical Center in Chicago are testing occipital nerve stimulation as a new treatment for migraine headaches.

The medical specialists say the treatment involves implanting a neurostimulator to deliver electrical impulses to nerves under the skin at the base of the patient's head at the back of the neck.

The researchers say the surgical procedure might help migraine sufferers who do not respond to other available therapies or who cannot tolerate the side effects of existing medications.

Rush study investigator Dr. Sandeep Amin said the purpose of the randomized, double-blind study is to evaluate the safety and efficacy of occipital nerve stimulation as a treatment for refractory migraine headache.

The study, known as PRISM, for (Precision Implantable Stimulator for Migraine), uses Boston Scientific's Precision neurostimulator. The device is the smallest rechargeable neurostimulator available and is already approved by the U.S. Food and Drug Administration for spinal cord stimulation to treat chronic pain.

A large study has found that people with IBS are more likely to experience other chronic conditions, including migraine disease:

High Risk Of Migraine, Depression and Chronic Pain For IBS Sufferers, Large Study Shows
individuals who reported symptoms of IBS were 40% more likely to suffer from depression and 60% more likely to suffer from migraine. The occurrence of fibromyalgia was 1.8 times greater in individuals with IBS than in control individuals.

I hate that anyone has migraines, but it makes me feel a little better when I hear about how they detrimentally affect the lives and careers of professional athletes in top condition. I hope it opens eyes among the general public, too, about the serious impact they can have on our lives.

Notes: Migraines end Otsuka's season
Rangers shut down closer because of severe headaches

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