Most U.S. Migraine Going Untreated

Survey finds just 1 in 20 sufferers gets preventive drugs

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HealthDay Reporter

THURSDAY, June 23, 2005 (HealthDay News) -- A new survey of more than 19,000 people with migraines suggests that a large number of American headache sufferers don't get proper preventive care.

Only about 5 percent of people with migraines reported taking drugs that could help stop the headaches, researchers found. "It means there's an intense degree of unnecessary suffering in the United States," said study investigator Dr. Stephen D. Silberstein, director of the Headache Center at Thomas Jefferson University Hospital in Philadelphia.

Migraine headaches, which affect an estimated 28 million Americans aged 12 and older, have long been notoriously difficult to treat. Doctors use a variety of drugs to prevent the headaches, including antidepressants, blood pressure medications and anticonvulsants.

Recently, neurologists have been turning to botulinum toxin type A (Botox), best known for its power to smooth wrinkles by paralyzing muscles in the face. Also, researchers report that new drugs known as triptans can ease symptoms in more than 80 percent of patients.

There are also a wide variety of alternative treatments for migraine headaches, which often start with changes in vision known as an "aura." Other migraine symptoms include nausea or vomiting, lightheadedness, tender scalp, sensitivity to light, and confusion, among others.

As part of the ongoing American Migraine Prevalence and Prevention study, researchers sent surveys to 120,000 households. Nearly 78,000 returned them and provided information about 162,576 people, of whom 19,018 -- or 12 percent -- appeared to suffer from migraines.

Researchers analyzed the survey results, and they were to report their findings Thursday at the American Headache Society annual meeting in Philadelphia.

Judging by the findings, an estimated 7.7 million Americans with the worst headaches should definitely take preventive drugs, while another 3.8 million should consider doing so, researchers reported. The other 16.3 million can get by with treatment as the headaches occur, they said.

But only one in 20 migraine sufferers reported taking such medications.

"Migraine is still under-diagnosed and under-treated," Silverstein said. "This means more with days with migraine, more disability."

Part of the problem is that many people, perhaps half, don't realize they have migraine headaches, said Dr. Frederick J. de la Vega, a neurologist with Scripps Memorial Hospital La Jolla in San Diego. "People will say they have a sinus headache, but that's basically just a layman's description of the headache they have."

While sinus problems may exacerbate migraines, often the sinuses have nothing to do with headaches, he said. But patients still try to treat themselves with drugs like Sudafed, he said. Other over-the-counter drugs, including common painkillers, can contribute to rebound effects, making headaches more frequent, according to de la Vega.

In some cases, patients resist getting medical help for migraines, he said. "A lot of people will say, 'I don't need to see a doctor, I only have them once a year, or a couple times a month, or around menstruation.' They don't see the need to go to an actual doctor to look at it."

The truth is that doctors can help just about everyone with migraines, although some patients won't get full relief, he said.

De la Vega's advice? If you think you have a migraine, "go to a doctor, preferably a neurologist, and have the headache evaluated completely, not only to confirm diagnosis of possible migraine, but also to rule out the possibility that the headache is the symptom of another underlying disease."

With proper treatment, he said, pain can be eliminated or reduced.

More information

Learn more about migraine headaches from the American Academy of Family Physicians.

SOURCES: Stephen D. Silberstein, M.D., director, Headache Center, Thomas Jefferson University Hospital, and professor, neurology, Jefferson Medical College of Thomas Jefferson University, Philadelphia; Frederick J. de la Vega, M.D., neurologist, Scripps Memorial Hospital La Jolla, San Diego; June 23, 2005, presentation,American Headache Society annual meeting, Philadelphia

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