Summer Newsletter 2016
I’m starting off this newsletter with a little house cleaning.
Quick Reminder regarding Prescription Refills: Please have your pharmacy fax us all prescription requests and allow 3 Business Days to be handled. If your request is for a controlled medication like Adderall or Hydrocodone, it can be requested in writing by sending our office an email request to email@example.com. Verbal requests for prescriptions will not be taken as it creates potential medication errors. For a more complete description of our prescription policy, please go to our website.
WHAT’s NEW FOR ACUTE MIGRAINE TREATMENT?
Onzetra is a new nasal delivery form of Sumatriptan
Onzetra is a new nasal delivery form of Sumatriptan that just received FDA approval. It is different than the current Sumatriptan and Zolmitriptan nasal sprays in that it is breath activated. It provides better delivery than current migraine nasal sprays and in clinical trials was well tolerated. This could be a good non-oral option for some migraine patients. For more information go to www.Onzetra.com
The SpringTMS (Transcranial Magnetic Stimulator)
The SpringTMS (Transcranial Magnetic Stimulator) is a device that recently was FDA approved for the acute treatment of migraine with aura. A magnetic pulse is delivered to the back of the head at the onset of aura. It is manufactured by eNeura and is a rental unit shipped once a prescription has been faxed to them. For more information go to www.eNeura.com. It is not yet FDA approved for migraine without aura.
Beta-blocker eye drops
Beta-blocker eye drops are showing evidence for acute treatment of migraine. In a small clinical trial, 7 patients used 1-2 drops of Timolol eye drops as early as possible in their migraine attack. Five of the seven patients reported complete pain relief. The other two reported significant relief of 8 and 9.5 on a 1-10 scale. Eye drops were well tolerated. Oral Beta-blockers are often used for prevention of migraine but would not work fast enough for acute treatment. The eye drops, in contrast, enter the nasal cavity through the lacrimal duct (passageway from the eye to the nose that drains tears). Once in the nasal cavity, the eye drops are rapidly absorbed into the bloodstream. This use of eye drops is not FDA approved but looks promising.
UPDATE ON PREVENTIVE MIGRAINE TREATMENT
CGRP Monoclonal Antibody Treatment
CGRP Monoclonal Antibody Treatment for prevention of migraine looks promising but is not yet FDA approved. Clinical trials are underway with Alder, Amgen, Lilly, and Teva Pharmaceutical. Treatment would be by injection or IV and could be as easy as a subcutaneous injection once a month. If you have an interest in participating in any current CGRP Clinical Trials, go to www.ClinicalTrials.gov
The Cefaly Headband
The Cefaly Headband continues to be helpful for many of our patients for prevention of migraine. It is worn 20 minutes once a day and has been FDA approved. We have 4 rental units for those interested. For more information, go to www.Cefaly.us
Clinical trials with the relatively new SpringTMS device
Clinical trials are underway with the relatively new SpringTMS device by having patients with migraine apply 4 pulses twice a day.
Trokendi XR will be getting FDA approved for prevention of migraine and can be a great option for those who like Topamax for prevention but experience fuzziness or what is sometimes called “Topamax Dopamax” side-effects. Trokendi XR is better tolerated and patients often report being more clear-headed.
Supplements called HeadAid
A new line of over the counter supplements called HeadAid is now available. Options include a daytime acute treatment option for migraine, a nighttime acute treatment, and a daily preventive. This line of products could be good for those looking for a more “natural” way to treat their migraines. For more information go to www.HeadAid.com
Lastly, I want to encourage all of you to get out and get moving! With increased daylight, there is no excuse for not getting out for that early morning walk or jog before or after work. My office staff and I recently participated in the Angels 5K and had some much fun we are planning our next 5 or 10K. Stay tuned as we may begin promoting patient participation with us for future athletic endeavors.
I enjoy putting together these Newsletters and hope you enjoy reading them. Feel free to suggest topics you would like addressed in future newsletters.
Have a wonderful summer. My office staff and I look forward to seeing you soon for a “tune up” of your migraine management.
Susan Hutchinson, MD Director-Orange County Migraine & Headache Center