HeadWise HeadWise: Volume 2, Issue 2 - Page 9

BLOCK OUT I get three to four migraines per month, sometimes with aura, sometimes without. I find that my biggest triggers are my menstrual cycle and stress. Given this, which medication is more effective for migraine prevention: beta blockers or calcium channel blockers? —Heather G. to trouble him severely once again. He has since had a CT scan and MRI and received treatment locally, plus he has been diagnosed with chronic paroxysmal hemicrania. The headaches are very severe, and sometimes he curls up in a fetal position on the bathroom floor. Sitting across from him, you can see the change in his face: swollen eyelids, etc. He is now on a new medication (but not indomethacin, which the Internet says is the drug of choice), but that too is not working all that well. He works in a dangerous, stressful job (as a therapy aide at a psychiatric hospital for the criminally insane), and we are not in a metropolitan area where there is great health care. He needs to work, doesn’t have a ton of time to travel here and there, and of course, there is always medical insurance, which plays a large part in care and treatment for anything. Is there anything he can do? Help he can obtain? A study to partake in? —Charlene R. There is no single answer to that question since these medications are selected on a very individualized basis. I think most headache specialists, myself included, would probably select a beta blocker before the calcium channel blocker, unless there are issues such as heart failure, asthma or other diagnoses that would be contraindications. Personally, I consider these medications second-line or “helper” drugs to add benefits to more commonly used first-line agents, such as amitriptyline or nortriptyline or the anti-epilepsy agents (e.g., topiramate or valproate) and others. Since you mention a relatively small number of headaches per month, a straight abortive plan (using triptans) may fit your needs—especially if you can eliminate some of your triggers—rather than using a daily preventive medication. Stress and the decline of estrogen levels at the end of a men Յ危ݥɅ́ɔѼȸMɕ́ɕՍѥѕՕ́Ս́хѥѼɕѥȁ彝ɔٕ䁡հ=ѡ́չ͕ȁɕ́Ёȁͭ́հ%ɕՅͥՅѥ̰幕́ȁɽɅѕ́ȁѥՅ危̸IȰѡɕѵЁ́Ёٽٔ䁵ѥ쁱屔ѡȁѽ́Ёͼ+Qչ5ͥ55! Ё1ͥ5() ѕȁ́ɔՍɔѡɽɽ͵Ʌ̀ A ѥձɱ䁥̸Q́ɔٕͥȰЁѕȁ́Յ䁽ȁȁݥ䁙Ȁѕ́Ѽݼ̰ݡɕ́ A х́ɔՍɥȁȁɔѕ丁 Ѡٔ唁ѕɥͅѥɔٕ͕ٕɔ A ɕ́Ѽѡݡɕ́ѕȁ́Ʌ䁑иeȁͽ́Ѽ͕䁄а́Ѡѡ͔幑ɽ́Ѽ䁕ɥ́+Q5ɬɕ55չЁMM59܁eɬ ()MYI9M]=118)5ĵ啅ȵͽ́ՕݥѠ́ȁЀԁ啅̸!́́ݕɔɕѕ䁥Uхє9܁eɬ쁅ѡɅٕѼɽЁݡɔ͕݅́ݥѠѕȁɕѕݥѠ5ѡɝ %ЁͽݡЁݽɭЁѡѡ́()YI%QdM!=\)'e٥́危ɽɅ̽䁡̽ѕȁ̸'e她Ѽչѥͥѥ́ݡ$ٔݡ她ɅѕѼٽɕչ̸́Ё䁝Ѽمѡ́ɽѼ䀡٥ 䰁ɥ ѡаɥѡаь$ٔi ()ܹ̹ɜ()()9ѥ!չѥ((((