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Migraine Research Foundation

Migraine Research Foundation

This news flash just landed in my email Inbox. Ann Scher, a 2007 Migraine Research Foundation grant recipient, published the results of her research in the June 24th issue of JAMA. Ann and her colleagues studied the incidence of late-in-life brain infarcts among Icelandic men and women who reported migraine in mid-life.

Most important, the researcher didn’t look at clinical evidence of stroke, but rather micro-strokes that may be symptomless, but cause changes in the brain visible on MRI. These micro-strokes may become symptomatic when they accumulate.

The researchers concluded:

 Migraine with aura in midlife was associated with late-life prevalence of cerebellar infarct-like lesions on MRI. This association was statistically significant only for women. This is consistent with the hypothesis that migraine with aura in midlife is associated with late-life vascular disease in the cerebellum and in women.

I found these results interesting because my mother, who is 87, has Migraine disease. Although she doesn’t experience acute attacks any more, she had them up until her 40s. Now, at 87, she has dementia precipitated by an accumulation of micro-strokes. Her MRI shows cerebellar changes resulting from these infarcts. Her mother experienced the same thing.

Although I don’t have Migraine with aura, I sometimes worry if I will meet the same fate. Even more reason for researchers and doctors to find new ways to prevent this chronic, progressive disease.

Comments

Hi all,

Just a quick note on which comments I will not approve.

  1. Comments that promote or even mention products that promise Migraine relief or cures. This excludes products or medications that are undergoing or have undergone randomized, double-blind studies. Studies must have been published in peer-reviewed journals. recognized by the medical community.
  2. Comments that are intended to harass, demean, or ridicule anyone.
  3. Comments that are intended to provoke arguments with the author or anyone posting legitimate comments.
  4. Comments that contain a link promoting a service or product. This includes links within a signature. This includes links to blogs that are essentially advertisements.

I do not intend to censor legitimate comments that promote resonable discussion. Therefore, if anyone has written such a comment that was not approved, please let me know.

Blessings,

Debbie

Levadex, MAP Pharmaceuticals’  orally inhaled medication for acute migraine, has met all 4 of the Phase 3 endpoints. In a news release issued on May 26, 2009 MAP Pharmaceuticals stated,

Patients taking LEVADEX therapy (formerly referred to as MAP0004) had statistically significant improvement at two hours compared to patients on placebo for each of the primary endpoints:  Pain relief,…Phonophobia… Photophobia,…and  Nausea….

Relief from nausea was particularly notable with more than two thirds of the study population gaining relief.

The Phase 3 study population of 792 Migraine sufferers had more severe migraine pain than expected with 100% experiencing moderate or severe pain.

courtesy of the Binghamton News

courtesy of the Birmingham News

Lynne Greenberg has done an amazing job writing about her relationship with chronic pain! My words can not do it justice. Lynne uses poetry to convey the emotion and the metaphors connected to her life with pain. Milton’s Paradise Lost is apt.

Her paradise lost was a promising career as a professor of English (17th century poetry is her passion) at Hunter College, a devoted husband and two children, and a host of friends. Then one day in August 2006 the Headache appeared and has not left. I was hoping for a resolution, some treatment that would remove her pain, or at least relieve it. Now, this is not to be, but she has learned to live with pain and re-enter life.

One lesson she learned is pacing. No, not the frenetic movements accompanying my trying to outrun a Migraine. Instead, it is slowing down enough to manage it. Poet T. S. Eliot describes it as”measuring out my life with coffee spoons” (The Love Song of J. Alfred Prufrock). What seems like a particularly dull life contains a lesson. Pace myself. I only have so many coffee spoons. Learn to say, no; take a break; slow down. All these can seem so simple to a healthy person, but to one coping with chronic pain, they represent tough choices and sacrifices. It is a necessity, not an option.

The book is an easy read, which may tempt readers to rush through it. I caution you to resist that temptation. Take it slowly; savor each chapter; let the lessons pain teaches become part of your life.

Grace,

Debbie

May 1, 2009 (Wow May already!) Early in 2008 Botox was associated with serious respiratory side effects and even death. Therefore, the FDA is revising the safety warnings and requiring a “Risk Evaluation and Mitigation Strategy” or REMS on the packaging.The drug is used for a variety of conditions including cosmetic enhancement, treatment of blepharospasm and severe dystonia. It is also used for off-label conditions such as spasticity in cerebral palsy, chronic Migraine, and MS. Dosages vary with larger doses for dystonia and spasticity. Read the whole story.

This is all well and good. However, how many patients know that there are severe side effects? How many of us have even SEEN the package insert? I may be naive, but I didn’t see it nor did I think to ask.

The upside is that Allergan is seeking FDA approval for using Botoxfor chronic migraine. Nothing really will have changed, but I guess there is some comfort knowing that Botox is an approved drug for migraine.

Older news:

Topomax or topiramate has gone generic as of April 1, 2009. The FDA reported that the drug would be marketed by a host of pharmaceutical companies including Roxane Laboratories Inc., Par Pharmaceuticals Inc., Mylan Pharmaceuticals Inc.,  and Barr Laboratories Inc.. One significant difference is that the prescribing information and labelling will differ from the brand name because not all of the patents and exclucivities have expired. Therefore, generic topiramate has been approved for siezures only. That is not to say that it won’t be prescribed off label for migraine prevention.

Along with Topamax becoming available in generic form, Johnson and Johnson is cutting 900 jobs in the Ortho-McNeil-Janssen unit due to a 35%sales decline for Risperdal, its biggest seller. Most of the job cuts will affect pharmaceutical representatives. So I guess having generic drugs available can be a detriment to some.

Life, Interrupted

Hello, gentle readers. Please excuse my absence from the blog world. Unfortunately, life interrupted my plans and my dear husband and I had to make an unexpected trip to PA. For the last month, instead of searching the web for new Migraine treatments, I was learning all I could about astrocytomas, radiation, and chemotherapy. When the dust settled, all ended ok.  “Benign” is what most people would prefer, but we heard  “malignant” , instead.

However, this was not as dark and desperate as it could have been. The patient is young and the tumor was removed completely. Chemo course is half what most people have to endure.

So now that the worst is behind us, I turn my focus to Migraine. Two articles have been recently published concerning the relation between Migraine and depression. Migraine and depression are comorbid diseases (as any migraineur can attest), but evidently the etiologiy has not been studied. Both of these studies are so new that they are currently not available. Look for updates.

In other news, Lynne Greenberg published her memoir, The Body Broken: A Memoir. I have not yet read the book, but Diana Lee’s post and the exerpt on Amazon were enough to get me to buy the book.

MediClim.com, a website that offers free information regarding the weather and chronic health condidtions. Sign up for the free service and you will get an email a day prior to weather changes that may affect your Migraine disease. Migraineurs could request time off in advance instead of waiting for the Migraine to strike. There are forums available. I joined.

courtesy of dbtechno.com

courtesy of dbtechno.com

This Chicago Tribune story came in my email this morning. In 2000, Diane Levine, who is a musician, was given Demerol and Phenergan for a migraine. Tragically for her, the physician’s assistant injected the Phenergan into an artery instead of a vein. Levine subsequently developed gangrene and had her right forearm amputated. Not suprisingly, she sued the clinic and the physician’s assistant for malpractice and received a $700,000 settlement.

What followed is tragic for all patients. Levine subsequently sued the drug company, Wyeth, for $7 million in damages, stating that there were not enough warnings on the label. In reality,  there are 6 warnings indicating that intra-artierial injection can result in gangrene. She won.

The FDA had already approved the warning labels on Phenergan. However, last week, the Supreme Court upheld the Vermont verdict. Unfortunately, and counter to present practice, it appears, in this case, the  Court  upheld that untrained juries could dictate what drug companies put on their labels instead of trained doctors and pharmacists, who comprise the FDA.

In the end, Diane won her case against Wyeth, but who loses? All of may lose. Migraineurs may lose. They may not want to take a drug out of fear. They may not be given approved, safe drugs for fear of a lawsuit. Drug companies may not develop drugs with severe side effects for fear of a law suit. We all may pay higher prices for drugs that we need. In the end, sick people are inadequately treated. Just like Justice Alito said in his dissent, “tragic facts make for bad law”. This is one of them.

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