CHICAGO, Ill., Aug 20, 2001 (United Press International via COMTEX) -- Despite new, effective medications for migraine headaches, a survey published Monday suggests that treatment for the often disabling pain hasn't radically changed over the past 10 years.

"The behavior of migraine sufferers has not kept pace with medical advances in the diagnosis and treatment of this disease," said Dr. Richard Lipton, professor of neurology, epidemiology and social medicine at Albert Einstein College of Medicine, The Bronx, N.Y. Lipton was lead investigator in the study, which appears in the current issue of the journal Headache.

Lipton said the study was based on questionnaires that included nearly 30,000 people in the United States and was conducted by the Chicago-based National Headache Foundation. Funded by a grant from GlaxoSmithKline, which markets a migraine medication, the study found:

-- About 28 million Americans suffer from migraine headaches, about 13 percent of the population. This is similar to what was described in the study Lipton and his colleagues conducted in 1989.

-- More than half of the people whose headaches meet a migraine's definition remain undiagnosed, although 48 percent of patients now do receive the proper diagnosis, compared with 39 percent in the previous study.

-- About 60 percent of patients continue to rely on over-the-counter medications for migraine, even though more effective prescription medication -- notably the class of drugs known as "triptans" -- are available. "However," Lipton told United Press International, "just because it is an over-the-counter medication doesn't mean it is not effective for some people."

Steven Graff-Radford, co-director of the Pain Center at Cedars-Sinai Medical Center in Los Angeles, did not participate in the study, but told UPI the survey shows some advances in treating people with severe headaches, along with a lack of treatment in people with milder forms of the disease.

"Physicians still don't see headaches as disabling," Graff-Radford said. And when patients take over-the-counter medications they may set themselves up for rebound headaches. In addition, he said, withholding triptan drugs early on can diminish their effectiveness later. Five different triptan drugs are available in the United States.

"Patients should be treated with the most effective drugs available for the individual," Graff-Radford said. He said that might be an over-the-counter medication or a prescription, depending on the person and his or her pain level. He suggested a "stepwise" procedure -- where more potent medications are added if pain is uncontrolled -- is an improper way to treat pain.

Lipton said that patients have to change their strategy in explaining headaches to their doctors. "If the patient tells the doctor, 'This pain is terrible,' the doctor is likely to say, 'There, there it will go away,' " Lipton said. "But if the patient says, 'I've missed three days of work because of the pain and I think I'm going to be fired,' or 'The pain is so bad I can't even diaper my baby,' then the doctor is likely to take notice."

"This is a case of 'Do ask and do tell,' " Lipton said. "Doctors should ask their patients about headaches and patients should tell doctors how those headaches interfere with their daily activities."

"Overall," Lipton said, "we found that treatment is much better and there is substantial improvement in diagnosis, but there is room for more improvement."

　　From Healthy.net