Saturday, February 16, 2008

migraine news roundup 52

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Migraine-related news has been hopping since the last Migraine News Roundup. Keep reading for information about the effectiveness of Trileptal in preventing migraines, warnings about dangers associated with the use of botulinum toxin type A injections and the possible connection between comatose locusts and migraineurs.

The results of a new study published in the February 12 issue of the journal Neurology indicate the epilepsy drug Trileptal (oxcarbazepine) is ineffective at preventing migraines. It had been thought to hold potential benefits because three other epilepsy drugs have demonstrated the ability to help prevent migraines.

Epilepsy Drug Doesn't Prevent Migraines

"It's good to do these types of double-blind studies to assess effectiveness of medications," said Dr. Walter J. Molofsky, chairman of the Department of Neurology at Beth Israel Medical Center in New York City.

"Since some antiepileptics are useful against migraine headaches, it would be reasonable to assume that Trileptal would work, too. This is an example of what is necessary to prove the presence or absence of benefit," Molofsky said.

The three epilepsy drugs that have been shown to prevent migraines, topiramate, divalproex and gabapentin, do so through several mechanisms. One mechanism is the regulation of the neurotransmitter called GABA. However, oxcarbazepine appears not to affect GABA activity. It is possible that epilepsy drugs need to regulate GABA to prevent migraine, Silberstein noted.

FDA links anti-wrinkle drugs to deaths
Botox is best known for minimizing wrinkles by paralyzing facial muscles — but botulinum toxin also is widely used for a variety of muscle-spasm conditions, such as cervical dystonia or severe neck spasms.

The FDA said the deaths it is investigating so far all involve children, mostly cerebral palsy patients being treated for spasticity in their legs. The FDA has never formally approved that use for the drugs, but some other countries have.

However, the FDA warned that it also is probing reports of illnesses in people of all ages who used the drugs for a variety of conditions, including at least one hospitalization of a woman given Botox for forehead wrinkles.
Allergan, which makes a well-known version of the drug under the name Botox said the doses given to the children who died is much larger than that used for cosmetic purposes.

The tendency of the locust to shut down into a coma when faced with extreme conditions, such as heat or lack of oxygen, bears similarity to the reaction of the human brain when overstimulated. This observation led researchers to wonder if treatments can be developed for migraineurs that could help prevent their migraines by studying the conditions under which comatose locusts become more stress tolerant and applying the same principles to humans.

Comatose Locusts May Help Relieve Migraines

However, it is not yet known whether the reaction to stress is actually the same in locusts and humans. While I have to admit it would be really cool if this line of research opened up a totally new way of addressing migraines, there seems to be a great deal of speculation involved in this approach.

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