A drug used in the prevention of migraine may also help reduce so-called rebound headaches, according to a new review of data from a randomized, double-blind, placebo-controlled migraine trial.
When the drug, atogepant, is taken every day, migraine-related pain can be alleviated, decreasing the need for additional painkillers, believed to be the source of rebound headaches.
The study was led by headache specialist Peter J. Goadsby, MBBS, MD, PhD of King’s College London in the United Kingdom, and a member of the American Academy of Neurology.
Its findings appear in the journal Neurology.There were 755 participants in the trial, each of whom experienced chronic migraine. Each had at least 15 days of headaches per month, with at least eight qualifying as migraine.
Out of the total group, 66% were overusing pain medications, which often occurs with people attempting to get rid of their headaches.
They were resorting to simple analgesics — such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or acetaminophen — for at least 15 days each month. Some took triptans or ergot alkaloids for at least 10 days. Some took a combination of both for at least 10 days in a month.
The trial began with a 4-week screening/baseline period.
At the beginning of the trial, participants averaged 18 to 19 migraine days per month, and were taking medications for pain for 15 to 16 days.
Next, individuals were randomly assigned to take 30 milligrams (mg) of atogepant twice daily, 60 mg of atogepant once each day, or a placebo for 12 weeks. A big problem with migraines is that people take too much medication, so we can get what’s called a ‘medication overuse headache’ or a ‘rebound’ headache. Goadsby also cautioned that some pain medications, such as NSAIDs, taken too often, can result in stomach ulcers and other assaults on the digestive tract.
Taking pain medicines can, paradoxically, increase the number of migraine days the patient has so-called medication overuse headache, so taking fewer pain meds stops that happening.A migraine is a severe headache that is classically characterized by throbbing pain, sometimes covering half the head.
It may be accompanied by an uncomfortable sensitivity to bright lights and loud noises — photophobia or phonophobia, respectively — with or without blurry vision or a visual aura, a difficult-to-describe symptom in which vision becomes prismatic.Generally speaking, when people get migraines, there is a blood vessel between the brain and the skull in your meninges, and when the blood vessel gets too big, it dilates. It tugs on the meninges which is the shock absorber of the brain. That usually causes the throbbing pain.
