Claim: Migraine drug could halve the length of attacks, study shows
Verdict: REFUTES

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title: Headache
text: many different possible treatments. In those with chronic headaches the long term use of opioids appears to result in greater harm than benefit. Migraine can be somewhat improved by lifestyle changes, but most people require medicines to control their symptoms. Medications are either to prevent getting migraines, or to reduce symptoms once a migraine starts. Preventive medications are generally recommended when people have more than four attacks of migraine per month, headaches last longer than 12 hours or the headaches are very disabling. Possible therapies include beta blockers, antidepressants, anticonvulsants and NSAIDs. The type of preventive medicine is usually chosen

title: Migraine
text: Prevention is recommended in those who have headaches more than two days a week, cannot tolerate the medications used to treat acute attacks, or those with severe attacks that are not easily controlled. The goal is to reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy. Another reason for prevention is to avoid medication overuse headache. This is a common problem and can result in chronic daily headache. Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. Guidelines are fairly consistent

title: Prevention of migraines
text: not have to be taken indefinitely. Sometimes as little as six months of preventive therapy is enough to "break the headache cycle" and then they can be discontinued. The most effective prescription medications include several drug classes. A meta-analysis found that propranolol had an "overall relative risk of response to treatment (here called the 'responder ratio')" was 1.94. Anticonvulsants such as valproic acid and topiramate. A meta-analysis by the Cochrane Collaboration of ten randomized controlled trials or crossover studies, which together included 1341 patients, found anticonvulsants had an "2.4 times more likely to experience a 50% or greater reduction in

title: Migraine
text: to standard treatment of a migraine attack, is associated with a 26% decrease in headache recurrence in the following 72 hours. Spinal manipulation for treating an ongoing migraine headache is not supported by evidence. It is recommended that opioids and barbiturates not be used due to questionable efficacy, addictive potential, and the risk of rebound headache. Ibuprofen helps decrease pain in children with migraines. Paracetamol does not appear to be effective in providing pain relief. Triptans are effective, though there is a risk of causing minor side effects like taste disturbance, nasal symptoms, dizziness, fatigue, low energy, nausea, or vomiting.

title: Migraine treatment
text: but they are an exceedingly potent cause of medication overuse headaches if used more than 10 days per month. Ergotamine and dihydroergotamine (DHE) are older medications still prescribed for migraines, the latter in nasal spray and injectable forms. They appear equally effective to the triptans, are less expensive, and experience adverse effects that typically are benign. In the most debilitating cases, such as those with status migrainosus, they appear to be the most effective treatment option. The most common adverse effects are nausea, vomiting, abdominal pain, generalized weakness, tiredness, malaise, paresthesia, coldness, muscle pains, diarrhea, and chest tightness. These are

title: Migraine treatment
text: with chronic migraine Preventive drugs are used to reduce the frequency, duration, and severity of migraine attacks. Because of frequent unpleasant and sometimes debilitating side effects, preventive drugs are only prescribed for those migraineurs whose quality of life is significantly adversely affected. The most commonly prescribed drugs for migraine prevention are beta-blockers, antidepressants, and anticonvulsants. The drugs are started at a low dose, which is gradually increased until therapeutic effects develop, the ceiling dose for the chosen drug is reached, or side effects become intolerable. The beta-blocker propranalol's effectiveness in headache treatment was a chance finding in patients receiving the

title: Prevention of migraines
text: to determine their efficacy in reducing the frequency or severity of migraine attacks. These drugs include beta-blockers, calcium antagonists, neurostabalizers, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), other antidepressants, and other specialized drug therapies. The US Headache Consortium lists five drugs as having medium to high efficacy: amitriptyline, divalproex, timolol, propranolol and topiramate. Lower efficacy drugs listed include aspirin, atenolol, fenoprofen, flurbiprofen, fluoxetine, gabapentin, ketoprofen, metoprolol, nadolol, naproxen, nimodipine, verapamil and Botulinum A. Additionally, most antidepressants (tricyclic, SSRIs and others such as Bupropion) are listed as "clinically efficacious based on consensus of experience" without scientific support.

title: Migraine treatment
text: significant reductions in the frequency of migraine episodes in patients with 3-12 headaches a month Adverse reactions related to topiramate treatment occurred in 82.5% of 328 subjects who took part in an extensive trial covering 46 different centres. Most commonly reported were paresthesia (28.8%), upper respiratory tract infection (13.8%, and fatigue (11.9%) The two main methods of rescue treatment are trigger avoidance, and acute symptomatic control with medication. Medications are more effective if used earlier in an attack. A serious potential problem with the frequent use of medications is the possible development of medication overuse headache, in which the headaches

title: Migraine
text: as triptans or ergotamines may be used in those for whom simple pain medications are not effective. Caffeine may be added to the above. A number of medications are useful to prevent attacks including metoprolol, valproate, and topiramate. Globally, approximately 15% of people are affected by migraines. It most often starts at puberty and is worst during middle age. In some women they become less common following menopause. As of 2016 it is one of the most common causes of disability. An early description consistent with migraines is contained in the Ebers papyrus, written around 1500 BCE in ancient Egypt.

title: Migraine
text: by around a third. Negative impacts also frequently occur for a person's family. Calcitonin gene related peptides (CGRPs) have been found to play a role in the pathogenesis of the pain associated with migraine. CGRP receptor antagonists, such as olcegepant and telcagepant, have been investigated both "in vitro" and in clinical studies for the treatment of migraine. In 2011, Merck stopped phase III clinical trials for their investigational drug telcagepant. Research as of 2016 is looking at CGRP monoclonal antibodies, of which four are in phase II development, three targeting CGRP itself and one targeting the receptor. Transcranial magnetic stimulation

title: Familial hemiplegic migraine
text: with FHM are encouraged to avoid activities that may trigger their attacks. Minor head trauma is a common attack precipitant, so FHM sufferers should avoid contact sports. Acetazolamide or standard drugs are often used to treat attacks, though those leading to vasoconstriction should be avoided due to the risk of stroke. Migraine itself is a very common disorder, occurring in 15–20% of the population. Hemiplegic migraine, be it familial or spontaneous, is less prevalent, 0.01% prevalence according to one report. Women are three times more likely to be affected than males. Also caused by calcium channel mutations: Familial hemiplegic migraine

title: Migraine
text: which involves decompression of certain nerves around the head and neck, may be an option in certain people who do not improve with medications. There are three main aspects of treatment: trigger avoidance, acute symptomatic control, and medication for prevention. Medications are more effective if used earlier in an attack. The frequent use of medications may result in medication overuse headache, in which the headaches become more severe and more frequent. This may occur with triptans, ergotamines, and analgesics, especially opioid analgesics. Due to these concerns simple analgesics are recommended to be used less than three days per week at

title: Migraine treatment
text: to use drug therapy because they experience unacceptable side effects, 3) patients who have to make too frequent use of abortive drugs such as the triptans or ergots, and 4) patients who would prefer not to be on permanent medication. Included in this category are those with Chronic Daily Headache (headache on more than 15 days per month) and patients with what is known as "refractory headache" - headache that has not benefited from any other form of treatment. Elliot Shevel, a South African surgeon, showed that patients with chronic migraine experienced a significant reduction in pain levels and significant

title: Migraine
text: Topiramate and botulinum toxin (Botox) are the only medications with evidence in treating chronic migraine. Botulinum toxin has been found to be useful in those with chronic migraines but not those with episodic ones. Long-term prognosis in people with migraines is variable. Most people with migraines have periods of lost productivity due to their disease; however typically the condition is fairly benign and is not associated with an increased risk of death. There are four main patterns to the disease: symptoms can resolve completely, symptoms can continue but become gradually less with time, symptoms may continue at the same frequency

title: Prevention of migraines
text: cases. A 2006 review article by S. Modi and D. Lowder offers some general guidelines on when a physician should consider prescribing drugs for migraine prevention: Preventive medication has to be taken on a daily basis, usually for a few weeks, before the effectiveness can be determined. Supervision by a neurologist is advisable. A large number of medications with varying modes of action can be used. Selection of a suitable medication for any particular patient is a matter of trial and error, since the effectiveness of individual medications varies widely from one patient to the next. Often preventive medications do

title: Lomerizine
text: 20 mg are not uncommon. It is also available in an intravenous solution of lomerizine hydrochloride, but the preferred route of administration, especially for treatment of the optic nerve, is oral. In a clinical study, long-term lomerizine usage was shown to be both safe and effective in the treatment of migraines. However, efficacy of the drug decreases with age, with a significant correlation between age and efficacy at preventing migraine attacks. Efficacies of 47% to 71% have been reported, and gender seems to have no effect on efficacy of the drug. Lomerizine may cause drowsiness and flushing, but it lacks

title: Migraine
text: in rating topiramate, divalproex/sodium valproate, propranolol, and metoprolol as having the highest level of evidence for first-line use. Recommendations regarding effectiveness varied however for gabapentin and pregabalin. Timolol is also effective for migraine prevention and in reducing migraine attack frequency and severity, while frovatriptan is effective for prevention of menstrual migraine. Tentative evidence also supports the use of magnesium supplementation. Increasing dietary intake may be better. Amitriptyline and venlafaxine are probably also effective. Angiotensin inhibition by either an angiotensin-converting enzyme inhibitor or angiotensin II receptor antagonist may reduce attacks. While acupuncture may be effective in reducing the number of migraines,

title: Prevention of migraines
text: part due to overuse of pain medications, and can result in chronic daily headache. Standards for the conducts of trials of preventive medications have been proposed by the Task Force of the International Headache Society Clinical Trials Subcommittee. Exercise for 15–20 minutes per day may be helpful for reducing the frequency of migraines. Diet, visualization, and self-hypnosis are also alternative treatments and prevention approaches. General dietary restriction has not been demonstrated to be an effective approach to treating migraine. Sexual activity has been reported by a proportion of male and female migraine sufferers to relieve migraine pain significantly in some

title: Migraine
text: migraine was, and some report impaired thinking for a few days after the headache has passed. The person may feel tired or "hung over" and have head pain, cognitive difficulties, gastrointestinal symptoms, mood changes, and weakness. According to one summary, "Some people feel unusually refreshed or euphoric after an attack, whereas others note depression and malaise." For some individuals this can vary each time. The underlying causes of migraines are unknown. However, they are believed to be related to a mix of environmental and genetic factors. They run in families in about two-thirds of cases and rarely occur due to

title: Migraine treatment
text: high incidence of unpleasant or debilitating side-effects that occur with migraine preventive drugs. Because of the complexity of migraine, no preventive treatment modality is effective for all migraine sufferers. However in FDA trials the Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss) had been proven to provide a 77% reduction of Migrain events in 82% of subjects tested. Practical Neurology Oct. 2005 The origin of the pain must be determined in each individual, and each contributory factor must be addressed. Most migraine sufferers have a combination of two or more of the following: a) vascular pain (pain originating in the arteries