HeadWise Volume 3, Issue 3 | Page 18

tients r Pa 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.