Migraine Relief: New Guidelines Highlight Natural Options

The newest guidelines for preventing migraines focus on prescription drugs, and tout the efficacy of several non-prescription and herbal options in fighting the debilitating headaches.

"Studies show that migraine is under-recognized and under-treated,” guideline author Dr. Stephen Silberstein of Jefferson Headache Center at Thomas Jefferson University in Philadelphia said in a statement. “About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them.”

More than 35 million people in the U.S. experience migraine headaches and estimates suggest they cost more than $20 billion each year, both in direct medical costs and loss of productivity.

The new guidelines, co-developed by the American Academy of Neurology which will publish them Tuesday, and the American Headache Society, found that several seizure drugs, including divalproex sodium, sodium valproate and topiramate, can be effective at curbing the frequency of migraines, as well as the severity of their attacks.

Many beta-blockers, which block the effects of adrenaline and help blood flow, were found to be effective at prevention -- among them, metoprolol, propranolol and propranolol.

But the new guidelines also looked at the role that non-prescription options can play in staving off migraines. Non-steroidal anti-inflammatories, which include ibuprofen, were found to be effective in preventing migraines, while magnesium, an extract of feverfew (a bush with daisy-like flowers) and riboflavin or vitamin B2 were all deemed "probably" effective.

In addition, petasites, an extract from the butterbur plant, was found to be effective in cutting the number of migraine attacks by up to 48 percent in some studies. The authors caution, however, that the safety of long-term use of the extract is undetermined and stress that even non-prescription treatments should be taken in consultation with a health-care practitioner.

"I'm very excited that butterbur gets the same rating based on the strong science (reviewed) as some of the prescription drugs," said Dr. Richard Lipton, director of the Montefiore Headache Center who led one of the studies that the guideline's authors considered. "Many headache specialists already use it. But for many physicians who don't focus on headaches, the guidelines will help underline the science."

Indeed, experts agree that one of the practical outcomes of the new guidelines is that health care providers who do not specialize in neurology, but who often end up treating patients for migraine, now have clear-cut recommendations. The guidelines help distill the broad body of scientific literature available.

"These sorts of guidelines are very important and they are based on a lot of hard work," said Dr. Michael Cutrer, chair of the headache division in the Mayo Clinic's department of neurology. "However, while they are a good starting point, we need to realize that they have many limitations"

The new guidelines, Cutrer said, also are based on recent studies and thus might reflect a publication bias toward newer treatment options. In addition, research suggests that the mechanisms underlying migraine might differ significantly, so what works for one person may not work for another.

Another issue, according to Cutrer, is that the new guidelines are based on the probability that treatments will be successful, and not how well individuals react to and cope with possible side effects.

"In guidelines like this, the main variable that they're assessing is the relative efficacy in trials. But what's probably equally important is whether or not the person is going to be tolerant of the drug," he said. "Some of the ones that perform very highly also have fairly high side effects."

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Comments

[Rich McIntyre]

09:00 AM on 08/06/2012

Maybe it's me. But I think it's awful that everyone is looking for the next best thing for the treatment of migraine. A small group of fellow victims have taken the same approach to these headaches and we have all had almost identical results. Elimination of flavor enhancers in all of their varied disquises, has had a positive result. Also called exitotoxins. Once I removed them from my diet, I was migraine free for 13 months! After 3 total wipeout migraines a month, I can tell you. It was freedom! No anxieties. Didn't have to worry or change plans or have to lock myself in a dark room! I still avoid MSG like the plague. It has been liberating. The philosophy is simple. The practice is hard. If you don't know what's in it. Don't eat it!!

[lurkitty]

08:02 PM on 07/12/2012

I found butterbur a few months ago and it definitely helps. Additionally, it helps my allergies. I highly recommend it!

[James Bogash]

06:09 PM on 06/19/2012

The frustration with treatment of migraines in medicine today is that the goal is merely the suppression of the headache. However, migraines are a systemic problem and are linked to things like stroke and cardiovascular disease. Merely medicating them, natural or otherwise, ignores the fact that there are serious underlying problems that need to be addressed.

[onwisconsin]

01:50 AM on 04/29/2012

I also just started a new program with my neurologist. I get DHE infusions when I have break-through migraines. This seems to work 3 out of 4 times.

[onwisconsin]

01:47 AM on 04/29/2012

We are a family of migraineurs. Helpful lately have been B2 (riboflavin) and CoQ10. My other preventatives change as we're trying to find something that works long-term.
If you try the CoQ10, the source is very important. Pilgram's Pride has an acceptable product. Buying it at one of the box stores or a chain pharmacy will not cut it. I take 300 mg of it and then 400 mg of B2.

[LadyAurora]

01:34 PM on 04/27/2012

I suffered from bi-weekly migrains most of my life. Tried the drugs but hated having to wait until one was coming before being able to take one. Always had to take the maximum dose for it to really work. Finally tried accupunture 4 years ago. I have not had a migraine since. I go every 3-4 months for a re-charge. Cheaper than the drugs and can also include other physical issues in the treatment, i.e. asthma, sleep problems, hot flashes, etc.

[DeniseA]

10:24 PM on 04/26/2012

I found that a very low fat diet helps.

[parabq]

04:45 PM on 04/26/2012

I used to have headaches and migraines everyday. Mostly in the am and would get worse. Got an air mattress and has taken care of most of it. Foam mattress's have formaldehyde. I was in Mexico and a natural doctor said to drink 1 cup of coffee squeeze in the juice of 2 limes and a teaspoon of coffee, all at room temp. Then lay down for 15 minutes. It works !!!

[donnabella]

08:44 AM on 04/26/2012

I suffer from chronic migraines. Tried the preventative topiramate but the effective dose was high, resulting in impared cognitive functioning. My neurologist told me "it makes you stupid," he was right, lol. Propranolol helps but so far, still get sidelined with migraines.

[NewGenerationNewIdeas]

06:16 AM on 04/26/2012

My wife suffered from chronic migraines, as often as 5-6 days a week. Tried all the drugs, none of them work as any migraine sufferer will tell you. I also got migraines, but perhaps only 4 or 5 a month, in addition to 'regular' headaches on a daily basis. 5 years later and she is down to 1 a month, and I am down to only a handful in a year.

You can take whatever remedies you want I guess, but the solution is finding what you are eating/exposing yourself to that is triggering migraines. For my wife it was MSG and sulfates/sulfites/nitrates/nitrites (food preservatives) and too much caffiene. My triggers are MSG, preservatives, balsamic vinegar, and the weed killer 'RoundUp'

Now we pretty much eat anything we want as long as its natural and has a few, pronounceable ingredients. No eating at Applebee's or China Buffet, but thats not really a loss anyway.

Don't just take my word for it. Check out the book '123 Heal Your Headache' on Amazon and just look at the reviews. I *promise* even for the most extreme migraine and headache sufferers out there, it will work if you give it an honest effort.

Good Luck!

[blueraccoon]

01:14 AM on 04/26/2012

I'm a chronic migraine and chronic headache sufferer - YES, they are two different things. I get headaches every day, migraines about once a week. I've tried everything. depakote - gained a ton of weight, went off it because it can cause birth defects. Topamax - gave me kidney stones. My BP's too low for beta blockers.

I just started Botox therapy but so far it's not helping the way I hoped it would. I take extended-release medication to keep my overall pain level low and occasional narcotics for when the migraines hit, and that's the best I've ever managed. I've also tried chiropractic, acupuncture, herbal remedies, massage, cranio-sacral therapy...you name it, I've tried it.

Migraines suck.

[NewGenerationNewIdeas]

06:21 AM on 04/26/2012

I totally feel your pain. Please see my comment on this article where I go in depth, but rest assured you can absolutely rid yourself of headaches.

Amazon search '123 heal your headache'.

Both my Wife and I suffered from chronic headaches and migraines, read that book, took it very seriously, and we have both had 99% reduction in headaches.

It isn't a bunch of BS. It isn't about 'adding' anything, like drugs, therapy, hypnosis or feverfew, it's about finding the root cause of your headaches 'triggers', and eliminating them. I assure you, relief is out there.

Good luck!

[janet41652]

10:13 AM on 04/26/2012

Thanks for the info. My daughter has had migraines for 20 years, and has taken 47 drugs hoping for something that works. I will have her read this article. F&F

[MsBonnieBarrow]

01:47 PM on 04/26/2012

I have severe migraine, classic mixed with tension and chronic headache. Not a day goes by that I dont have a headache and there have been numerous times that my migraines have sent me to the ER, even multiple times in a week. I started the botox a year ago. I still have headaches every day but I have not been to the ER for them in about 8 months so I take that as a small win. I hope it works for you!

[krmcphee]

07:29 PM on 04/25/2012

I just started herbal treatments a few months back with my acupuncturist. I normally have 1-2 migraines a week, and a headache EVERY DAY. This week I didn't have a single headache. Not one. Not even a tiny little one. This is the best I've ever felt. I am totally a believer in herbal/natural treatments for headaches, and will continue to go this route.

www.lifemindvitamin.com

[goldy67]

01:04 PM on 04/25/2012

I am a migraineur, and the three classes of drugs doctors recommend are a joke. You are trading problem A (migraine) for problem B (horrendous side effects of drugs). Here's the rundown from bitter experience. Beta-blockers--feel like zombie, can't exercise, need to take midday nap. Barely functional at work. Tricyclic antidepressants--hospitalized for rapid heartbeat. Felt like I was going to DIE. Topamax--after disastrous experiences with other two I'd have to be an idiot to try something that is known to cause cognitive problems. What works? Acupuncture from a knowledgeable Chinese doctor. Magnesium and Coq10. Botox. Cut down or eliminate caffeine. Exercise. If you still get an attack, take aspirin or ibuprofren, get acupuncture, and rest. These new drug recommendations are ridiculous. Their efficacy isn't even all that great. Can't remember-- but I read the studies and was not impressed. The side effects of these drugs are on par (in terms of loss of function) with the migraine for many people. And doctors don't want to hear it. They say "well the drug isn't supposed to do that" or "well, would you rather have a migraine?" instead of actively looking for natural treatments.

[Cheyenne Tiera]

05:14 AM on 04/26/2012

So true. And if you read the Hippocratic Oath, you just can't believe these physicians take it seriously. I recommend reading it. It's a beautiful document.
We have to come to terms with the fact that the drug companies are educating the doctors. So we have to take responsibility for educating ourselves, something we were never taught to do. But it's so worth it.
You may want to read my recommendations on Feverfew for migraines.

[goldy67]

07:45 AM on 04/26/2012

I was afraid to try feverfew because I have a ragweed allergy, and I read somewhere that it is the same family. I'm not sure though. I am trying to formulate a question to present to my next doctor to weed out the pill pushers. it will go something like this: " I'm not looking for you to listen to me for five minutes and write a prescription. I'm looking for you to work with me as a whole person to find the BEST treatment overall. That may or may not involve drugs, and it may take some time. Can you do that?" When I mentioned that one drug caused insomnia once, the doctor, immediately told me to take Ambien. I looked at him like he had six heads, like "WHY would I want to drug myself coming and going" and he looked at me like "WHY wouldn't you?" That says it all.

[Cheyenne Tiera]

07:17 PM on 04/26/2012

I'm very sorry for your struggles. Migraines are awful.
Trying to get an uneducated doctor, who thinks (s)he is educated, to listen to that kind of request is literally like talking to a wall and feel frustrated that it's not listening and responding back.
He's not trained to help you find a natural remedy and you simply cannot get him to do something he's not capable of. What you're asking is completely counter to his training and mind set. It sounds like to have enough on your plate in just dealing with the headaches.
If you have a good natural food store nearby, you can ask the person in that department to muscle test you for feverfew since you think you may be allergic. Also, are you taking drugs of any kind? If so and you don't feel safe going off them, take the drug(s) with you for the muscle testing to see if your body responses to a drug interaction. Do it this way:
1. muscle test with the feverfew first (any form of it is ok)
2. muscle test with the feverfew and drugs together.
Did you read my post on feverfew?
Did you read the other posts?
Let me know if I can help further.

[BruntLIVE]

08:31 AM on 04/25/2012

I didnt know light skinned people worry.

[forestwalkerjoe7]

10:39 AM on 04/26/2012

Are you Kidding me with this?

[Cheyenne Tiera]

05:46 AM on 04/25/2012

I was plagued with debilitating migraines for many years until I tried the herb, Feverfew, in a liquid extract form and it was very effective. I rarely have them and if I do, they are very mild and manageable. I founded an herb company in 1972 and I've been using natural healing methods for many years, When people tell me something doesn't work for them, it's usually because they don't understand how to apply the principles of dosage in the use of natural remedies.
If you have migraines and want to try a natural remedy, you can simply reply to my post and I will reply to yours with instructions. Then you can do your own research and decide if you want to try remedies that are safe and non-invasive.

[anoise]

12:13 PM on 04/25/2012

Do you take Feverfew everyday? or just at the onset?

[Cheyenne Tiera]

05:09 AM on 04/26/2012

Feverfew is preventative only. Once you find the liquid extract (usually at a natural food store, herb shop, or online), you have a high potency product which is what you want. With natural remedies, you need to get as much of the remedy into your system as you can, then you can taper off later. I took about a dropperful 5 times a day to start (which is much more than what the label will recommend because they err on the side of being conservative about dosages). But with a safe remedy, it's not a problem to use your own method of dosing.
I did that for about 3-4 days, tapered down to 3 times a day. After about 2 weeks, 1 time a day. Then after getting no migraines for so long, I stopped.
Now when I get them, rarely, they are mild.
Feverfew is probably one of the least expensive of the natural remedies for migraines on the market.
If you are taking medications, you can reply to me again and I will respond on the subject of drug interactions. We only get a limited amount of space on each posting, so I have to stop here.
Hope this helps.
PS. I first heard of feverfew from the medical doctor who was very popular on national radio and had researched it quite a bit. It was easy to take his advice because I have over 30 years of success stories with natural remedies.