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Long-term Outlook : The Future of Migraine

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Q: What does the future hold for migraine sufferers?
A: Migraine remains underdiagnosed in the US, where just half of some 28 million people with migraine have been properly diagnosed. Failure to recognize migraine and its misdiagnosis as another headache type are the most common reasons for this. Many migraine sufferers have been diagnosed with tension or sinus headache because their symptoms do not fit the regular criteria. Studies show that pain on both sides of the head, nonthrobbing pain, and pain at the back of the head and neck are common in migraine, but as these are generally associated with tension (stress) headaches, this diagnosis may be made instead. The medical community and the public need to be better educated about migraine and migraine sufferers.
Q: Why are men generally not diagnosed as having migraine?
A: Studies have shown men are associated with a lower probability of being diagnosed with migraine. Men are reluctant to seek healthcare for any medical problem, and headaches are often assumed to be caused by stress.
Q: What are the economic costs of migraine?
A: Migraine is a chronic illness that results in significant suffering and economic loss. It has been estimated that migraine affects nearly 6.2 million workers employed outside the home and results in lost productivity valued at 1.4 billion dollars per year. Studies show workdays lost annually to migraine ranging from 1.4 to 4, but none of the studies consider the impaired productivity of individuals who continue to work with a migraine attack. Experts estimate the annual indirect cost of migraine in the US to be between 1.4 and 17.2 billion dollars.
Q: Will we ever have a fail-safe test for migraine?
A: I am sure that someday we will have a diagnostic test for migraine. Researchers have tried to find a biological marker on DNA but have found little, so far, that seems promising. The development of imaging studies may provide the first breakthrough. At present, the diagnosis is made by asking the headache sufferer about his or her history of headaches and the family history.
Q: What are the recent advances in migraine?
A: Recent advances in the study of disease mechanisms and diagnosis have given us a better understanding of what causes migraine, and we are better able to choose the right medications to treat migraine attacks, rather than just treating the pain of a headache. The current theory of the multimechanism of migraine allows us to target different areas of the brain causing the attack. The combination of triptan and nonsteroidal anti-inflammatory drugs (NSAIDs) enables people to stop attacks more effectively.
Q: Are there new treatments for migraine prevention?
A: Researchers are now turning their attention to migraine prevention. For years, medications developed to treat other diseases have been used to treat migraine. As we discover how the illness of migraine progresses and what may make certain individuals more vulnerable to its progression, we will be able to find improved treatment options. The future does hold much hope for the migraine sufferer.
Q: What is the ultimate goal for migraine treatment?
A: Now that we understand migraine to be a progressive disease, achieving a pain-free outcome is the ultimate treatment goal of patients. A migraine attack must be treated early and aggressively to achieve the pain-free outcome within 2 hours. The longer an attack lasts, the more vulnerable you are to another attack.
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