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An Update fo
Gary Ruoff, M.D.
Westside Family Medical Center,
Kalamazoo, MI
Migraine has never been a big subject in medical school. But it is
one of the most common reasons patients seek medical care. Those
of us on the front lines know that a correct diagnosis and effective
treatment can make all the difference. Without quality care,
someone who starts with an occasional attack can end up with a
chronic condition that needs the attention of a specialist.
About 15 years ago, a team of headache experts created
basic, “evidence-based” guidelines–nstructions for how
and when to use each drug–to help non-specialists treat
migraine patients. Besides recommending how and when
to use medication, the experts also suggested that anyone
who treats patients with migraine should try to:
1. Involve them in caring for their own condition
2. Make final decisions about treatment with their
patients, not just for them
The point is to make sure everyone understands the
game plan, just like the coach and players on a good
sports team.
It has been a long time since the guidelines were
published, and that is why I am writing this article.
18
HeadWise™
|
Volume 3, Issue 3 • 2013
When I realized how many studies have been published
since then, I noticed that there might be some room for
change and improvement. I also saw that patients could
start putting this kind of cutting-edge information to
practical use immediately.
Acetaminophen (Tylenol®)
For more than a decade, doctors have been told not to
use acetaminophen for migraine. But at least two studies
have shown that as long as the attack does not make you
vomit or need to lie down, acetaminophen may be able to
help relieve the pain of a migraine attack. Its effect on the
other symptoms of migraine (nausea, etc.) is less clear.