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Migraine? Relief Is Heading Your Way

Wanted: New Drugs -- and New Patients

As impressive as they are, the current crop of migraine drugs are not enough.

"For many patients the triptans are a godsend," Penzien says. "Triptans are the first drugs to come out of the lab directly into the pharmacy specifically for treatment of headache. So it is kind of exciting for us that we know more about headaches now and can actually devise treatments that will help. On the other hand, if you listened to the drug companies when they were getting ready to introduce the first triptan, we headache specialists would have thought we'd be out of business soon. Well, I still see as many patients as I used to see. The triptans are a very useful tool, but not a cure. We still ... have patients who have headaches every day and for whom triptans aren't an option. We are not even close to being out of the woods."

So what's coming next?

"We are going to have a new group of preventive drugs," Diamond predicts. "There is going to be some variations on the triptans and some new drugs dealing with substance P [one of the brain's pain-message molecules], which may further work to control acute headache pain. And I think that as we look into the hereditary factors that are so prominent in migraine, we will be seeing some gene therapy that will one day be effective."

Until these new drugs come along, the biggest advance is one that already is possible. People who are suffering in silence must know that they can come forward and get help.

"There has been a lot of stigma associated with having headaches -- they are seen as a psychiatric illness," Penzien says. "But I can sit here as a psychologist and say they are not psychological problems. Unfortunately, there is a stigma, which comes from the fact that everybody gets headaches. We say 'Well, when I have headache I just take aspirin and get on with it. Why do you go to bed all day?'

"Also, migraine and tension headache are primarily women's disorders because estrogen is a major migraine trigger," Penzien says. "We tend to give less attention to diseases that affect primarily women. I think that is part of the reason migraines are undertreated."

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