Migraines Can Mean More Than Just Headaches

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Migraines Can Mean More Than Just Headaches

Sufferers May Be More Prone to Asthma, Back Pain, Depression

By Jeanie

WebMD Medical News

Reviewed by Dr.

Sept. 18, 2000 -- For those who push through the day despite migraines, it's

not news that these sometimes severe headaches can seriously affect a

person's quality of life, day-to-day functioning, and state of mind.

Now, two new studies in the journal Neurology map out -- for the first

time -- the full toll that migraine can take on a sufferer's life.

The researchers say that other chronic conditions -- such as asthma, back

pain, and depression -- often also plague migraine sufferers and should be

treated as well. The studies point up the need for doctors to ask more

questions, to talk to patients about life-affecting issues beyond the

headache. With improved medications that have become available in the last

few years, migraine is more treatable than ever before, the researchers

emphasize.

The first study found that migraine sufferers had " significantly diminished

functioning and well-being, compared with those who didn't suffer

migraines, " author Lenore J. Launer, PhD, chief of neuroepidemiology at the

National Institutes of Aging, tells WebMD. And the more migraine attacks a

person had, the worse his or her quality of life.

Launer's study, conducted in the U.S. and the Netherlands, focused on 620

men and women suffering from migraines. The researchers surveyed these

patients by telephone to assess their quality of life during a migraine,

asking about their physical functioning (such as going to work, cooking,

shopping), social functioning, emotional well-being, general mood, pain,

energy level, and overall health.

To put the data into perspective, Launer compared the migraine sufferers'

quality of life with that of people suffering from asthma and chronic

musculoskeletal pain. These conditions share some characteristics with

migraine -- the episodic attacks of asthma, and the debilitating nature of

chronic back pain.

Launer found that people with migraines were significantly more likely to

also have asthma and chronic back pain -- which created a worse quality of

life than migraines alone.

People with migraines " may need other services or programs to help them get

through the day, " Launer tells WebMD. Doctors should be asking their

migraine patients about other aspects of their lives, she adds: " They need

to treat more than just the headache; they should investigate how people's

daily lives are going. For many people, having a migraine means they have to

simply stop functioning in their daily activities. "

Launer also uncovered another common problem. A full 54% of subjects in her

study did not have a diagnosis of migraine from a physician, she tells

WebMD. " Many people are still not seeking treatment when there's a whole set

of new drugs available, " she says.

Another study finds a " highly significant link " between depression and

migraine, says author B. Lipton, MD, professor of neurology and

epidemiology at Albert Einstein College of Medicine in the Bronx, N.Y.

In a survey of 468 people in the U.S. and 261 in the U.K., Lipton found that

those with migraines had significantly lower quality-of-life scores than

people without migraines. Not surprisingly, " we also found that as

headache-related disability got worse, quality of life got worse, " Lipton

tells WebMD.

Researchers also found a " link that confirms what we've known -- that

depression and migraine often coexist, " Lipton says. In his study, 47% of

migraine sufferers had depression, compared to 17% of people without

migraines.

But depression does not always accompany migraine, Lipton tells WebMD. " The

two disorders are clearly separable disorders; most people who have one

don't always have the other. "

Which condition controls quality of life? Lipton says he had thought

depression might be the determining factor, but that's not necessarily so.

" Migraine and depression independently affect quality of life, " he tells

WebMD. " If you have migraine and not depression, you still have

substantially reduced quality of life. "

Too often, says Lipton, physicians consider depression a byproduct of

migraine -- " Of course you're depressed. You get migraines every week. " And

some doctors treating depression may consider a patient's headache complaint

to be a manifestation of the depression.

" Quite likely they are separate problems that require treatment, " Lipton

tells WebMD. " Some medicines that prevent migraine also prevent depression. "

Calling the two studies " large and well-designed, " Werner J. Becker, MD,

writes in an accompanying editorial that they " advance our knowledge of

migraine. " It's also clear, adds Becker, " that many patients with migraine

never see a physician for their headaches, and many who do are never

referred to specialists. "

In fact, earlier this year the U.S. Headache Consortium released

comprehensive guidelines to help doctors aggressively diagnose and treat

migraines. Silberstein, MD, director of the Headache Center at

Jefferson University Hospital in Philadelphia, headed that effort.

" Migraine is starting to get more respect, but it still is not recognized

[by all physicians] and lot of people are still not seeking treatment, "

Silberstein tells WebMD.

Doctors know that migraine often accompanies other conditions, such as

depression, stroke and epilepsy, says Silberstein. " What [the Launer study]

suggests is that migraine is more commonly associated with asthma and

chronic musculoskeletal pain, " he says. " What this tells you is that the

inflammatory process in the lining of the brain may be similar in migraine

and asthma; that may be a common mechanism for both. As for the prevalence

of back pain, it could be that the pain-control system may be defective in

those with migraines and [in] back-pain patients. "

Further, he tells WebMD, " Patients who have asthma, chronic back pain, or

depression might be having so many problems they may be ignoring their

headache. "

Lipton's study was sponsored by Pfizer, a company that makes both

antidepressant and antimigraine drugs.

For more information from WebMD, see Diseases and Conditions page on

Migraines/Headaches.

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