Thursday, June 18, 2009

Cambia - New Migraine Medication is Approved

Cambia was approved June 17, 2009 by the FDA for use in the United States for the treatment of Migraine. It does not prevent nor lessen the number of attacks, but is designed to treat one already in progress. Cambia comes as a flavored powder to be mixed with water to form a solution which is drunk by the patient, preferably on an empty stomach.

Drugs.com reports that, "In randomized clinical trials, Cambia was shown to be effective not only in migraine pain, but also in treating photophobia (sensitivity to light), phonophobia (sensitivity to sound), and nausea commonly associated with migraine attacks. It was also shown to provide statistically significant onset of relief of migraine pain within 15 to 30 minutes." This is statistically much faster than the vast majority of oral Migraine medications on the market today.

Cambia is another hybrid medication. Hybrid medications like Cambia combine 2 or more previously known and used medicines. When used together, they combine and work synergistically together to create a formulation that is more powerful than the sum of either ingredient when taken separately.

The main ingredient - diclofenac sodium - has previously been known as Cataflam and Voltaren. It is an NSAID and carries all the normal warnings and contraindications of this class of drugs, but its safety profile was better than Triptans. In this case, diclofenac was blended with a unique buffering agent - potassium bicarbonate (usually used in higher doses to treat low potassium levels) which acts as the 'engine' that boosts the effects of diclofenac. Normally NSAIDs are taken with food to help prevent the gastric upset that is so common with this type of drug, but in this case the unique buffer makes it preferable to take without food, making the preparation an advantage for Migraineurs who suffer vomiting and nausea as a part of their attacks.

Unfortunately, Cambia comes flavored using aspartame and saccharine which may be a problem for some patients. As an oral preparation, patients with gastric stasis may still not be able to absorb Cambia well, although there is no research on this to date. Diclofenac has also been found rarely to cause drug-induced Lupus, and is contraindicated for patients suffering SLE, Lupus autoimmune disease. Other contraindications for the use of diclofenac include asthma or frequent runny nose or nasal polyps, porphyria, liver or kidney disease or swelling of hands or lower legs. Diclofenac can also cause bleeding or bruising problems.

Sources:
Genetic Engineering and Biotechnology News
Drugs.com
MedlinePlus
Medicine.net

Thursday, January 15, 2009

Migraine triggers and the Block Theory

'The Block Theory' is a simple way of looking at how your body reacts to Migraine triggers.

Migraine triggers are things that might have the tendency to make the brain more sensitive, and start the cascade that is the beginning of a Migraine attack. Migraine triggers range from things you can control such as the foods you eat, to things beyond your control such as the weather, lighting or hormone fluctuations.

In The Block Theory, each trigger is worth a specific number of building blocks... you know, the pretty colored cubes you built towers with as a child. If fluorescent lighting is a particularly bad trigger for you as it is for me, it might be worth as many as 5 blocks. Something milder for me such as a change in weather might only be worth one block.

Every time you come into contact with a trigger, The Block Theory says to take the blocks and pile them one on top of the other, forming a tower.



Childhood experience has probably taught you that you can only pile a certain number of blocks on top of each other before your tower comes crashing down. In The Block Theory, that crash is the beginning of your next Migraine attack.

Each person is different. Mr. Handsome might be able to handle an enormous pile of 20 blocks before the tower falls and he suffers a Migraine. Ms. Chronic may have suffered so many back-to-back attacks that a tiny tower of only 4 or 5 is enough to send her into a Migraine tailspin.

Making it even more difficult to predict your next Migraine, building blocks are accumulated over a period of as many as 3 or 4 days for any single tower.

Do you remember everything you ate, drank or did 4 days ago? I usually can't remember them all, even when I try.

The Block Theory is why it can be so difficult to identify your own personal Migraine triggers. There are an infinite combination of triggers that can add up, in the right circumstances, to a Migraine attack.

Finding your Migraine triggers is difficult, but not impossible. It takes patience. Most people never know all of their triggers. As time passes, the number of blocks for each trigger may change, further confusing the situation. Many Migraineurs usually know at least one or two of their Migraine triggers however, so avoiding those is a good place to start.

What are your triggers? Do you have any strange triggers that cause you special problems? Your experience might help someone else discover a trigger they had never thought of before! Read about one of my strange triggers HERE.

More Migraine trigger information:

Tips for living successfully with Migraine Disease:

What is Acephalgic Migraine?

Wednesday, January 7, 2009

MIGRAINE INTERRUPTED FAQ's

Frequently asked questions-

Why did you choose to title the blog, Migraine Interrupted? I am a chronic Migraineur. I live every day with pain, and my dream is that someday my Migraine will be interrupted.  Also, it reflects the painting I chose to head this blog.

Why did you feature the painting in the title box?- I'm an artist at heart. When I saw it, it reminded me of times spent working despite Migraine, and my husband's gentle touch as he soothes me. Painted in 1750 by Francois Boucher, the title of the Rococco styled oil painting on canvas is "Interrupted Sleep".

Why is everything black?  I am very light sensitive.  Creating this blog in black allows me to feel better as I go back and read entries because the color is relaxing to my eyes.  The text is in grey or gold because it is bright enough I can see it, but is not so much contrast that it hurts my head.

Why did you create this blog? I write about Migraine because it helps to reinforce new information in a brain dulled by medications that make life survivable. I needed a place to store my files and thoughts, so when I'm asked for information I have a quick place to access it and share it. Every time my computer crashed, I lost chunks of research. I found blogging allowed me to store what I had learned and compiled, and share it with others searching for information. Health literacy is the responsibility of us all. If you don't have it, get it. If you have it, share it.

Where is the information for the newly diagnosed? I was newly diagnosed 28 years ago. That's a full generation. Most of my entries are going to reflect the things I'm still trying to better understand today, or new discussions, or new research, trials or drugs. Sometimes I'll add my own voice.  For now, there are so many wonderful places online for those new to Migraine, I love to refer back to their capable hands instead.

What is your point of view? From the path less traveled. That of someone in a difficult situation who has tried everything conventional, and searching for something different. A nearly fatal reaction to a Migraine treatment in the ER got me going, and my children - also Migraineurs - keep me going. I am looking to better understand how my body and nervous system work both individually and together, and how different treatments affect my system. I don't want to compete with other sites, but to complement them. To add another voice to those who are no longer willing to be the "good patient who doesn't ask questions". One more voice to those looking for the truth. One more place to find information, and one more person who understands. I want to learn all that I can so that my children won't have to suffer as I have. I'm just one person. I can't begin to "save the world", but maybe I can help protect just three of them. If a single voice is mighty, what more might a whole chorus be able to accomplish?! Harmony is accomplished with multiple notes in the same key...

Why don't you refer back to more patient sites in your articles? You can find many of them on my blog list, and if I've put them there, it's because they are awesome. I learned long ago that my doctors are only interested in physician's sites however, so my information focuses there. Much of the information I'm going through is not found on patient focused sites, or is incomplete for my uses. I try to make it easier to understand, and put the pieces together in one place. I'm a pest and question my doctors until I'm satisfied with the answers. Admittedly I sometimes shift into another gear altogether, so if I use an unfamiliar term, just comment with a question and I'll explain it or link you to someone who can. If you're another blogger and want to write a simplified version of an article, please send me a link to it and I'll include it here. What's important is getting the information out, not who does it.

Why don't you use more/fewer links in your articles? Some readers like a lot of links in the text, others are more comfortable with fewer or no links. I'll have a mixture of both. They're informational or supportive only, you don't have to click them. Some will go back to WEGO Health or Migraine.com where literally thousands of pages are accessible to the newly diagnosed and their physicians. These sites contain information that changes as updates are discovered or placed online.

Why are the posts so long? I am unconventional in many ways. Blog posts are usually short ditties with tiny bits of information. I find those posts only have me hunting elsewhere for info. I get sidetracked, and confused. I don't like clicking. Mostly, you'll find my entries are articles meant to discuss or explain a subject in detail. It's that detail that is difficult to find elsewhere. For Migraineurs who have 'been there, survived that' it is the detail that finally brings clarity. My physicians take me seriously when I know and understand the finer points.

Why do you include comments, opinions, experiences? Because we all need to know we're not alone. Each Migraineur is different, and so are their experiences. I'm a difficult case so I have a number of stories to share that might be useful. You'll find some of them here. Even when I'm angry I will always be respectful. Comments, opinions are my own and reflect my feelings and impressions the day they were written. Comments and opinions are not fact however, so please seek out others to compare them. Go to the source. Consider everything, then formulate your own opinion. Never take any single person's/group's word for anything - look it up yourself. If you want to place a comment about something I've written, I ask that you be respectful and informative. I welcome all respectful comments, positive or negative, and will post those that are helpful to myself or readers.

What about updating? Fortunately, Migraine research has taken off with the launching of awareness campaigns and drug company advertising. The constant flow of new and changing information makes Migraine a fluid topic. I will try to update pages as information becomes available, but sometimes I am overwhelmed by the sheer amount that hits my inbox daily. To be fully informed on any subject, I urge you to subscribe to many different blogs and sites from a variety of authors. Join a community and actively participate. If you're not comfortable with that, I invite you to send me questions, or information you've found on your own and I'll help you research it.


Why MIGRAINE INTERRUPTED?

 About Me

When I first saw the painting at the top of my blog, it reminded me of times spent working through a Migraine - attempting to be normal - while my husband lightly touches my face and worries over me. The photo of the Baroque and Rococco painting at the top of Migraine Interrupted is by Francois Boucher in 1750 and is called "Interrupted Sleep".

I began blogging as a project for WEGO Health.

About me




My name is Ellen Schnakenberg and I'm the chronic Migraineur behind Migraine Interrupted and several other blogs and websites devoted to Migraine, headache and chronic pain disorders.

I'm a 48 year old Missourian who began city life on the west coast, and now live on a quiet farm near Iowa. I am married to 'D' and together we have a grown son and daughter. 
A part time blogger, Migraine and chronic pain community and newsletter contributor, I was discovered online and then hired at the website WEGO Health and spent several years researching, writing and advocating with them as a community leader, as well as helping other health activists network and become better at advocating and educating patients utilizing various social media platforms. Much of the rest of the time I spent educating, advocating for and sharing my experiences with other everyday people who wish to become proactive in their own and their family's health care, including working with the media. 
I now work for Migraine.com as a patient advocate/educator and community manager, helping the amazing team of patients and doctors there develop a useful platform of support and education for both patients and physicians.  
I stay current on the latest and greatest information by attending American Headache Society's annual scientific meeting as well as their fall symposium, and actively participate each year in the (AHDA) Alliance for Headache Disorders Advocacy's Headache on the Hill in Washington, DC. 
I am also an Ambassador for the United States Pain Foundation.
Although I've been active in online websites and communities approximately 20 years, I've been blogging about Migraine and other health related issues since March 2008, starting with my first still located in the WEGO Health site. 
Due to multiple personal and family diagnoses I began to be asked to cover other health subjects including:
  • Cluster and other headache disorders
  • Dystonia and tardive reactions
  • Autoimmune diseases including lupus, Graves' disease, Hashimoto's thyroiditis, Sjogren's syndrome and others.
  • Nutrition, vitamin deficiencies, complementary and integrative health care  
  • Chronic pain
You can find me:

Twitter @ESchnak                        Putting Our Heads Together
Facebook                                     AHS ACHE blog
Learni.st                                       Headache Disorder Blog Network  
stumble.upon                                Migraine.com blog
Love.it


There are many good, informative websites now, unlike 30 years ago when my Migraine journey began. 

My wish: to add one more voice to those who no longer accept living in the dark. One more explanation of what Migraine is and is not. One more person to offer support to another looking for ways to live with Migraine disease. One more place to go for connections to other bloggers and websites who can help.

In my old life I worked with children, managed an Arabian horse farm/reproduction facility, was an emergency dispatcher and an award winning artist. I also volunteered with kids and animals, running successful programs for each of which I'm very proud. I am a medical First Responder, and still keep my spoon in many of these pots including CERT (Community Emergency Response Team), Search and Rescue teams, 4H programs and my church.

As you'll be able to tell from my blogs, I'm descended from photography and travel nuts and I love my horses, dogs and cats.
I hope that's given a glimpse of where I'm coming from. If you're a Migraineur or headache sufferer and want to learn more about these disorders and how you or someone you love can live well despite their symptoms, then I'd love to keep in touch. You can subscribe to this blog via one of numerous subscription methods by clicking the SUBSCRIBE TO button below the blog title. Additionally, I'd love to hear from you about Migraine or other headaches in the comments sections on my posts.

This page was last updated June 1, 2012

Migraine medicine- new hope for treatment and prevention

Migraine hope

Phase IIA trials on a brand new drug identified as ADX10059 which modulates (not blocks) a specific glutamate receptor have been completed, and European based Phase IIB trials are beginning. This drug represents an entirely new drug class and a new way of looking at Migraine. This preliminary trial of 129 patients showed success in the acute treatment Migraine. The drug's record in treating Migraine attacks in the trial was found to be similar to that in Triptan trials. Triptans work primarily on blood vessels however, and many patients cannot tolerate them. ADX10059 is reported in this trial to have very few, mild side-effects. Phase IIB trials are targeting the drug toward the initiation of Migraine, by way of prevention and long term management of Migraine disease. Results are expected in 2010.

ADX10059 shows promise in providing Migraineurs with a neural or nerve -based therapy. Topiramate is currently considered by many to be the Gold Standard nerve-based prevention/treatment for Migraines today, but it has a high incidence of side-effects, some serious. Those taking ADX10059 were able to tolerate very high doses of the drug without significant side-effects.

Dec 19, 2008 Medical News Today - "Research has shown that glutamate is the major neurotransmitter involved in the initiation and the propagation of the migraine circuit, a positive feedback loop that leads to pain and inflammation in the brain and hence migraine symptoms."

ADX10059 is also in trial for gastro esophageal reflux disease (GERD) and showed promise for use in that disease as well. A special twice daily formulation dramatically reduced side effects of dizziness, drunk feeling and flushing in that study.

A third, phase II trial of ADX10059 for anxiety was completed, but did not have the desired result for the specific type of anxiety tested. No serious adverse reactions occurred.

Niagra Falls (photo copyright 2008 Ellen Schnakenberg)

More studies include:

*levodopa induced dyskinesia (PD-LID - a type of movement disorder).

Inhibition of mGluR5 also has potential in Fragile X syndrome (a genetic disorder).