Experts at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health, have warned patients against resorting to an overuse of painkillers for regular migraines as it adversely impacts the effectiveness of prescribed preventative treatments and care management. Around one in seven people in the world suffer from migraine, making it the third most common disease.
Migraine is the leading cause of disability from all neurological diseases. It remains undiagnosed and undertreated in a majority of the population. People with episodic migraine suffer from 14 headaches or fewer each month, while those with chronic migraine typically suffer from 15 or more headaches during the same period. Genetic, hormonal, and lifestyle factors can contribute to the condition. Dr. Ranjith Menon, the section head of the headache program at the Neurology Institute at Cleveland Clinic Abu Dhabi, says that they are increasingly seeing patients whose episodic migraine has progressed to chronic migraine largely because of medication overuse. “
Medication overuse headaches, also called rebound headaches, are caused by the frequent or excessive use of painkillers and abortive antimigraine drugs to treat acute attacks. While they may relieve momentary pain, these medications can trigger subsequent and worse headaches. Patients who overuse such medications to abort their ongoing attack have an increased risk of developing chronic migraine in the long run,” he says. Dr. Menon explains that the main cause for medication overuse is the patient’s desire for fast relief and an incorrect treatment plan that is not tailored to the patient, which has a considerable impact on their quality of life. “We see patients who have had such headaches for more than 15 years and have been taking abortive medications for so long that they have made the situation worse. Patients may also end up resorting to unsupervised over-the-counter use of painkillers when their prescribed treatment is not working, or are in a hurry to see results.”
As there is no cure, he says that the only way to contain them is to find the right preventative plan based on the patient’s medical history and associated comorbidities. Treatment includes a lifestyle overhaul with a good diet, proper hydration, and sleep hygiene; appropriate preventative medications, including antidepressants, blood pressure lowering pills and anti-seizure drugs; and/or newer drugs which block the Calcitonin Gene-Related Peptide (CGRP) protein, or its receptor, that may cause inflammation and pain in the nervous system, which leads to migraine attacks.
Cleveland Clinic Abu Dhabi’s headache program also treats patients suffering from chronic migraine with Botox injections. Botox helps block chemicals called neurotransmitters that carry pain signals from the brain, making it a successful treatment option to prevent migraines in a growing number of patients at the hospital. “These drugs gradually prevent attacks and reduce the frequency, severity and duration when taken as prescribed. However, there is no single treatment that is effective for every migraine sufferer. Patients must discuss various treatment options with their doctor to find a successful pathway to manage their specific condition.”
Cleveland Clinic Abu Dhabi