Q. I have had migraines for approximately 20 years. I have bad months in which I have 6-10 days of headaches. The last month has been better since I started on Topamax for migraine prevention. However, I am feeling anxious and wondering if there is an anti-anxiety medication that is recommended. What are your thoughts about BuSpar and Paxil?

Q. I have had chronic daily headaches and migraines with aura for years. I also have fibromyalgia, TMJ (temporomandibular joint syndrome) disorder and irritable bowel syndrome (IBS). All of these involve chronic pain. I take Relpax® for the migraines, which helps a lot with the aura and works okay for the headache. I also take Cymbalta® for depression, but haven't noticed any pain relief from it. The only other medication I seem to tolerate is Advil®. Since I have a headache “24-7”, with no beginning or ending, I never really know what causes it. How many pain relievers (like Advil) do you have to take to get a rebound headache? I never take more than two a day, but I wonder if taking them for several days makes my headache worse. I want to do anything I can to prevent an already difficult situation from getting worse.

Migraine is linked to an increased risk of suicide and other self-inflicted injuries, according to researchers at Oxford University in England. While certain psychiatric illnesses, such as depression, bipolar disorder, and schizophrenia, increase the risk by five times of self-harm, common physical illnesses also elevate the risk. In a recent study, patients with epilepsy were about three times more likely to intentionally harm themselves, while people who have migraine or asthma were nearly twice as likely to do so. The study indicates that the skin disorders psoriasis and eczema also carry an increased association, as do inflammatory conditions such as arthritis.

  googleThe recent recession in the United States impacted individuals’ well-being as well as their finances, according to a recent study. Health-related Google inquiries, particularly for stress-related ailments, spiked between December, 2008, and December, 2011 — the period frequently described as the Great Recession. Researchers say that during that time, online searches for information on stomach ulcers increased by 228 percent, and headache inquiries followed closely with a 193% increase, translating to an excess of 1.48 and 1.52 million searches for those two ailments alone. Among the top 100 health complaints that were searched, there were more than 200 million queries about health concerns than would be expected. The numbers remained high, ranking considerably above the pre-recession threshold as the economy improved toward the end of 2011.

Migraineurs have twice the risk of developing depression as those without migraine, and researchers have learned that the disorders may be connected in a striking way: The combination of the two has been linked to smaller brain size in older adults. In a recent study, the brains of patients with migraine and depression had about 2% less volume than the brains of people who experienced neither or only one of the disorders. The information is not alarming, researchers said, but more study is warranted to fully understand the connection and its implications, including if the smaller volume is accompanied by a decline in cognitive abilities.

Physical and mental health disorders, including depression and anxiety, often afflict migraineurs, with current research indicating that panic disorder (PD) is the anxiety disorder most often associated with migraine. In a review article in the January issue of the journal Headache, Todd Smitherman, PhD, FAHS, from the University of Mississippi, and colleagues explored PD, migraine and the connection between the two to better understand assessment and treatment of affected patients.

Treating migraine brings multiple benefits to migraineurs, including improvement of psychological and social problems that frequently accompany the disorder, new research indicates. In a review of studies published between 2000 and 2010, researchers found that among migraineurs with and without aura, the most common psychosocial difficulties (PSDs) included: fatigue; emotional problems, especially depression and anxiety; difficulties at work, such as decreased efficiency and absences; problematic social functioning and global disability, which encompasses all the psychosocial problems a person experiences because of migraine. 

More than 37 million Americans suffer from migraine. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache. Many factors can trigger migraine attacks, such as alteration of sleep-wake cycle; missing or delaying a meal; medications that cause a swelling of the blood vessels; daily or near daily use of medications designed for relieving headache attacks; bright lights, sunlight, fluorescent lights, TV and movie viewing; certain foods; and excessive noise. Stress and/or underlying depression are important trigger factors that can be diagnosed and treated adequately.