Tuesday, November 13, 2007

migraine news roundup 48

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A study in the November issue of the journal Headache establishes the prevalence of depression among headache patients. Patients with headache are generally recognized as suffering a high rate of major depressive episode (MDE), but this study identified the factors that indicate a greater likelihood of experiencing MDE among headache patients.

Indicators of A Major Depressive Episode in Headache Patients

Analysis revealed that severe headache, longer duration of headaches, multiple somatic symptoms, and being a distressed high utilizer were associated with MDE. Multiple logistic regression analysis revealed that patients with headaches lasting 6 months or longer and those with multiple somatic symptoms were more likely to be suffering from MDE.

According to a survey commissioned by the Canadian Pain Society, veterinary students receive three times the training as medical students in pain management.

Vets Receive 3 Times More Training on Pain Than Doctors and Nurses
"All the veterinary colleges had way more hours than medicine, nursing, dentistry (and) pharmacy," said lead researcher of the study, Judy Watt-Watson.

Researchers have identified two genetic markers in individuals who are at greater risk of suicidal thoughts.

Two Gene Markers Heighten Suicide-Ideation Risk

"We were a little surprised by the magnitude of association between the genetic markers and the suicidal ideation," Gonzalo Laje, M.D., a psychiatrist and a clinical research fellow at the Genetic Basis of Mood and Anxiety Disorders program at NIMH and the lead author of the study, told Psychiatric News. "The two markers seem highly specific, which is rare in genetic testing in psychiatry. The study shows that we are on the right path to understanding this phenomenon."

He cautioned, however, that these results need to be independently replicated by other studies involving other patient populations and other antidepressants.

Consumer Reports
has launched a new service aimed at helping people make sense of prescription drug advertisements.

Consumer Reports Starts Ad Watch

Research seems to indicate that migraine patients are more likely to have restless leg syndrome (RLS) than the general population. According to the journal Cephalagia, 17 percent of the migraine group had RLS while only 6 percent of the control group had the condition.

Comorbidity of Migraine and Restless Leg Syndrome

There may be a higher risk of Sudden Infant Death Syndrome (SIDS) in the children of people who have been hospitalized for mental illness or substance abuse.

Mental Illness in Parents Tied to Higher SIDS Risk

In families with a parental history of psychiatric hospitalization, either fathers or mothers, the risk of SIDS was roughly doubled compared with the frequency seen in the general population, the authors report in the Archives of General Psychiatry. If both parents were hospitalized, the risk of SIDS was increased by nearly 7-fold.

For specific disorders, the greatest risk was associated with inpatient treatment for substance abuse. The risk was especially high if mothers were hospitalized, which increased the risk by 5-fold.

For mood disorders, such as depression, the risk was increased by about 2-fold for hospitalization of the mother or father.

Contrary to previous reports, schizophrenia-like disorders did not increase the risk of SIDS more than other psychiatric disorders.

A recent study established that laughter helps children cope with pain.

Watching Funny Shows Helps Children Tolerate Pain Longer

discusses how chronic pain patients have coped since Vioxx was taken off the market.

Q&A: Post-Vioxx, Pain Relief Remains Complicated

People largely have been taking non-steroidal anti-inflammatory drugs (NSAIDs). These include the generics naproxen (sold under the brand names like Aleve) and ibuprofen (Advil, Motrin). These drugs have always been associated with significant rates of GI bleeding when taken for weeks or months at a time. Doctors often prescribe a drug called a proton-pump inhibitor to protect the GI system from the damage that NSAIDs and aspirin can cause.

One COX-2 inhibitor remains on the market — low-dose (200 milligram a day) Celebrex. The Food and Drug Administration has placed warnings on the drug cautioning that life-threatening cardiovascular side effects have occurred with related drugs. Some studies have shown that Celebrex at higher doses does increase the risk of heart attacks and strokes. The drug should not be used right before or right after certain heart surgeries.

Preliminary research shows that memantine (Namenda) holds promise for migraine prevention.

Women and Migraines
[W]omen suffer from severe headaches, known as migraines, three times as much as men. A possible reason? A phenomenon called "cortical spreading depression."

Dr. Andrew Charles: "It's actually a spreading wave of electrical activity that moves across the surface of the brain very slowly."

This is a CSD wave moving across the brain of a mouse, signaling the start of a migraine headache. studies showed female mice were far more susceptible to these waves than males. scientists don't know why - or what triggers the waves.

But, Dr. Charles found a drug that blocks these waves called Namenda, or memantine - usually used to improve memory in alzheimer's patients.

"In a study of chronic migraine sufferers, 60% of those who had taken memantine reported that the frequency of their headaches had been cut in half."

Patient advocate Teri Robert recently provided an update on Headache on the Hill, a movement advocating policies that take the unique needs of headache patients into consideration and support research on headaches and migraines.

Headache on the Hill Update
Early next year, we'll be asking all of you to email your Senators and members of the House regarding this issue. We're building a special Web site where you'll be able to easily and quickly put together powerful emails to send directly from the site.

An LA Times article discusses the benefits of mindfulness meditation for coping with and managing pain.

Doctor's Orders: Cross Your Legs and Say 'Om'
In a new study, published in October in the journal Pain, Natalia Morone, an assistant professor of medicine at the University of Pittsburgh, tracked the effect of mindfulness meditation on chronic lower back pain in adults 65 and older. The randomized, controlled clinical trial found that the 37 people who participated in an eight-week mindfulness meditation program had significantly greater pain acceptance and physical function than a similar size control group. Subsequently, the control group took the same eight-week program and had similar results.

"When there is pain, the rest of the body tenses up," Salzberg said. "Then you have tension plus pain. Or there's judgment: 'I shouldn't be feeling this way.' Mindfulness allows us to see what the add-ons are and discover what the actual experience is right now."

Increasingly, doctors across the country are recommending meditation to treat pain, and some of the nation's top hospitals, including Stanford, Duke and NYU Medical Center, now offer meditation programs to pain patients.

According to a study published in November 13, 2007, issue of the journal Experimental Biology and Medicine, the acne drug Accutane leads some patients taking it to become depressed because of its effect on their serotonin levels.

Mechanism for Acne Drug's Link to Depression Suggested by New Research

Using cells cultured in a laboratory, scientists from the University of Bath (UK) and University of Texas at Austin (USA) were able to monitor the effect of the drug on the chemistry of the cells that produce serotonin.

They found that the cells significantly increased production of proteins and cell metabolites that are known to reduce the availability of serotonin.

This, says scientists, could disrupt the process by which serotonin relays signals between neurons in the brain and may be the cause of depression-related behaviour.

“Serotonin is an important chemical that relays signals from nerve cells to other cells in the body,” said Dr Sarah Bailey from the Department of Pharmacy & Pharmacology at the University of Bath.

“In the brain it is thought to play an important role in the regulation of a range of behaviours, such as aggression, anger and sleep. Low levels of serotonin have been linked to depression, as well as bipolar and anxiety disorders.

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