Migraine Connect
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4yr

50-year-old female reports having ~10 migraine days per month with some migraine attacks lasting longer than 12 hours. She is currently on topiramate for migraine prevention and has escalated through various acute medications/combinations with  increasing use recently. As a working mother with three school-aged children, her increased absenteeism and presenteeism is causing her substantial anxiety and stress.



Currently, this patient has a BMI of 26 and is post-menopausal.



What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?


  • 4yr
    Possibly use an abortive Rxs, the goal of abortive treatment is to stop a migraine once it starts. Use of CGRP antagonists - rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) or Show More
  • 4yr
    I would start her on aiMovie do to the number of headaches and the disruption of her life

Show More Comments

  • Saved

made a Post

4yr

50-year-old female reports having ~10 migraine days per month with some migraine attacks lasting longer than 12 hours. She is currently on topiramate for migraine prevention and has escalated through various acute medications/combinations with  increasing use recently. As a working mother with three school-aged children, her increased absenteeism and presenteeism is causing her substantial anxiety and stress.

Currently, this patient has a BMI of 26 and is post-menopausal.

What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?

  • 4yr
    Possibly use an abortive Rxs, the goal of abortive treatment is to stop a migraine once it starts. Use of CGRP antagonists - rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) or Show More
  • 4yr
    I would start her on aiMovie do to the number of headaches and the disruption of her life

Show More Comments

  • Saved

made a Post

4yr

50-year-old female reports having ~10 migraine days per month with some migraine attacks lasting longer than 12 hours. She is currently on topiramate for migraine prevention and has escalated through various acute medications/combinations with  increasing use recently. As a working mother with three school-aged children, her increased absenteeism and presenteeism is causing her substantial anxiety and stress.



Currently, this patient has a BMI of 26 and is post-menopausal.



What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?


  • 4yr
    Possibly use an abortive Rxs, the goal of abortive treatment is to stop a migraine once it starts. Use of CGRP antagonists - rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy) or Show More
  • 4yr
    I would start her on aiMovie do to the number of headaches and the disruption of her life

Show More Comments

  • Saved

4yr
Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review - Current Pain and Headache Reports

Gender Minority Stress, Psychiatric Comorbidities, and the Experience of Migraine in Transgender and Gender-Diverse Individuals: a Narrative Review - Current Pain and Headache Reports

Source : https://link.springer.com/article/10.1007/s11916-021-00996-7

Purpose of Review This review aims to discuss the experience of migraine in transgender and gender-diverse individuals as it relates to other psychiatric comorbidities such as anxiety, depression, PTSD, and...


Summary: Research has demonstrated that stigma and discrimination can affect health outcomes in the transgender and gender-diverse community. A recent study has shown that sexual minority stress associated with stigma, discrimination, and barriers to care can exacerbate migraine. It is known that psychiatric comorbidities such as anxiety,...

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4yr
Increase in ACC GABA+ levels correlate with decrease in migraine frequency, intensity and disability over time - The Journal of Headache and Pain

Increase in ACC GABA+ levels correlate with decrease in migraine frequency, intensity and disability over time - The Journal of Headache and Pain

Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-021-01352-1

Background An imbalance between inhibitory and excitatory neurometabolites has been implicated in chronic pain. Prior work identified elevated levels of Gamma-aminobutyric acid + macromolecules ("GABA+") using magnetic resonance spectroscopy (MRS)...


Conclusion: The correlation between an increase in ACC GABA levels with improvement in clinical characteristics of migraine, suggest previously reported elevated GABA levels may not be a cause of migraine, but a protective mechanism attempting to suppress further migraine attacks.