Do migraines put you at increased risk for car accidents? What's the down side of four FDA-approved drugs for migraine treatment? And what could "monoclonal antibodies" mean for the future of migraine prevention? These are such important questions if you suffer from migraines! In this issue, we look at why-and what the answers mean for treating and preventing your own migraines.

Thank you all for sharing questions, ideas for upcoming issues and comments about your own experiences. We enjoy hearing from all of you, including the doctors who read and comment on our articles.

Tina Sanders

Linpharma Customer Education


Driving Dangers: Migraine Aura, Pain and Meds

A few years ago, a Virginia woman crashed her car into parked vehicles. She claimed her impaired driving was due to a migraine attack. Even so, she was convicted of a DUI and lost her license. She's not alone. Driving can be a "danger zone" for many migraine sufferers.

For starters, migraine attacks can begin at any time. The first signals-auras-can include vision and even blinding, disorienting and debilitating visual disturbances and nausea. Even if symptoms aren't so severe, auras can disrupt judgment, driving skills and reaction time (some sufferers report blowing through red lights without even realizing they were there). The pain of the attack can incapacitate a driver. Plus, even if it's possible to take preventive medicine, side effects can include dizziness, drowsiness, confusion and weakness that are downright hazardous for someone behind the wheel of a car.

So, if you suffer chronic migraines, what must you know about driving?

Rules of the Road for Migraine Sufferers

1. Know the law and the side effects of migraine drugs. You can be charged with driving under the influence-and with criminal liability-if you knowingly drive while taking a medication that carries warnings about dizziness and drowsiness or not operating machinery or driving a vehicle. Note that all four of the FDA-approved migraine preventives come with warnings about these kinds of side effects.

2. Pull over as soon as you can. If at all possible, pull over. If it's not immediately possible, drive slowly in the right lane until you can pull onto the shoulder or a side street.

3. Call someone to pick you up. If you suffer from chronic migraines, be proactive in finding a reliable back-up driver you can call if you're on the road when a migraine strikes.

4. Emphasize prevention. Do all you can to minimize the frequency and severity of your migraines. Plus, to avoid side effects like dizziness, drowsiness and "brain fog," emphasize natural prevention options. A Swedish study, for example, found exercise to be as effective as Topamax® (topiramate) in migraine prevention. There is also documented evidence showing the effectiveness of supplements such as butterbur, magnesium, Vitamin B2 (riboflavin) and CoQ10 for migraine prevention.

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"FDA-approved" doesn't mean "risk-free"

Many drugs are used to treat acute migraine attacks. Still others are used "off label" as migraine preventives. But when it comes to FDA-approved choices for migraine prevention, four drugs are generally prescribed: the beta-blocker drugs propranolol; and timolol and the anti-seizure drugs divalproex sodium and topiramate.

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Just because these drugs are FDA-approved doesn't mean they are free of risks. In fact, these drugs carry significant concerns involving drug interactions and potentially fatal side effects.

While even vitamins, supplements and exercise can come with cautions, it's important to understand that many of the side effects listed for Rx migraine drugs are considerable and common. For a PDF comparing the drug interactions, warnings and side effects of these four migraine preventives, CLICK HERE.


Monoclonal Antibodies for Migraine Prevention

Many of you may have seen a New York Times article by Michele Willens, "Where is the Cure for the Migraine?" In that article, Willens mentions the promise of monoclonal antibodies. What are they?

In the simplest terms: Calcitonin gene-related peptide (CGRP) is a neuropeptide that increases during migraine attacks. Monoclonal antibodies are substances being developed to block CGRP activity. Doctors believe blocking the CGRP pathway could actually prevent an attack.

While FDA approval of monoclonal antibodies is still years away, the treatment holds important promise for migraine sufferers: Not only could monoclonal antibodies prevent migraines, they could prevent migraines with less potential for liver toxicity, drug interactions, and concerns for patients with heart problems compared to the anti-seizure and blood-pressure-lowering drugs currently being used for prevention. We'll keep you posted as more research is conducted.

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