Migraine Chronic Pain Management

Written By: Dr. Stephen F. Grinstead, LMFT, ACRPS, CADC-II Date: June 3rd, 2009. Topic: Member Blogs.

As anyone who ever experienced a migraine headache knows it can be extremely debilitating—I know this first hand as someone who experiences periodic migraines and in fact had one of my most serious episodes all day today. It was once again imperative that I practice what I teach; although today I did not do as good a job as usual but I did learn some valuable lessons yet again.

One thing I believe is that unless a chronic migraine patient goes to a treatment provider who understands appropriate interventions for this condition, they can run the risk of unnecessary pain and suffering, including the possibility of prescription drug addiction. Many people are given opiates for migraine treatment even though they are not an FDA approved medication.

Medications Used To Manage A Migraine
Headache Fall Into Two Broad Categories

Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms that have already begun.

Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Unfortunately, in the realm of Migraine treatment, little emphasis is placed on whether the medications have been specifically FDA approved for the treatment of Migraine since so few are FDA approved for the prevention of it. In fact, there is not a single medication that was originally developed for Migraine prevention. All were originally developed for other purposes. When it comes to treating Migraine attacks (acute treatment), however, this is not the case. There are seven triptans (Imitrex, Maxalt, Zomig, Amerge, Axert, Frova, and Relpax) that were developed for and FDA approved as Migraine abortive (management) medications. These medications work to actually stop the Migrainous process in the brain and stop the Migraine attack and its associated symptoms.

Ergotamine medications (used as vasoconstrictors for migraine prevention and are sometimes mixed with caffeine) such as DHE and Migranal; they are also FDA approved for Migraine treatment as is Midrin (a combination of acetaminophen, dichloralphenazone, and isometheptene). The NHF study also involved prescription pain relieving medications, which cannot abort a Migraine, as well as the triptans. Thus, the issue here is not so much FDA approval of acute medications, but the difference between using “generic pain medications” as opposed to Migraine-specific medications.

To learn more about this topic—as well as other postings on headache pain management—please go to our research page and scroll down to the posting titled Information and Guidelines for Migraine Management that you can download for free on our News & Research 2008 Archive page.

If you would like to be skill trained in a treatment model that teaches how to implement a multidisciplinary treatment plan we have an Addiction-Free Pain Management® 20 Hour Certification Training scheduled this Spring at Valley Forge Medical Center and Hospital in Noristown PA on June 10-12, 2009. It’s not to late for people to sign up and in fact by mentioning this Blog I will make sure you get a $20 discount for this training. To get this discount you must call my partner Ellen at (916) 575-9961 and ask her for the discount. Also, for this and other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people in chronic pain and want to learn how to develop a plan for managing their pain and coexisting psychological disorders including depression or addiction effectively please go to our Publications page and check out my book the Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

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