5242760927_f8c8b41aba_o Patients with medication overuse headache (MOH) may benefit from stress reduction and healthy changes to their lifestyle, according to a new study from Denmark. “High stress plus smoking, low physical activity, or obesity has synergistic effects in MOH. So, stress reduction is highly relevant in MOH management,” said Rigmor H. Jensen, MD, in Neurology Reviews. Dr. Jensen is a Professor of Neurology and Director of the Danish Headache Center at the University of Copenhagen; she presented the study in May at the International Headache Congress in Valencia, Spain.

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.

Q. I have been on Depakote® and amitriptyline for migraines since about 1996. I kept the headaches reasonably under control (I've had them since 1985) with those two preventive medications and lifestyle management (strict diet, regular exercise, enough sleep and decreasing stress). I do, however, have moderately severe arthritis of the neck from a car accident in the 1970s. For the past year, I have had a migraine every day except four intermittent days; I can't figure out what I could be doing wrong. I avoid rebound headaches by alternating my use of Norgesic Forte® with Tylenol 500®, or when necessary, Imitrex® or Amerge®. I'm careful not to take more than the prescribed amount of any medication. My question is this: Would Neurontin® be of help to me? Has Depakote ceased to be effective? Or could the arthritis in my neck have finally won the battle I've been having with it? My neck pain is excruciating at the end of a work day, especially if I've had a headache. Neck pain is one of the precursors to a migraine for me.

Q. Can headaches be a symptom of a wheat allergy? I know it's not usually listed as a food trigger, but I have started getting more frequent headaches after doing really well for a long time. The only thing I can think of that's different in my diet is that I started snacking on a lot of wheat crackers and eating more bread. Nothing else in my life, including stress, exercise, sleep, work, or medications, has changed.

More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. They are 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.

HOW COMMON IS MIGRAINE IN WAR VETERANS?

Migraine is extremely common in war veterans. In fact, one study reported that 36% of those returning from Iraq after deployment for Operation Iraqi Freedom experienced attacks of migraine-like headaches. Another study reported that 37% of soldiers with concussion injuries had headaches within one week of the concussion. Of these headaches, 91% had characteristics of migraine headache.

The first controlled study to assess the combination of preventive drugs and behavioral techniques for hard-to-treat migraines found that using the techniques together leads to better outcomes. The study enrolled 232 people with frequent headaches that weren't controlled by acute medicines. They were randomly assigned to receive preventive medications (a beta blocker), behavioral management, both or neither. After 16 months of follow up, the combined approach offered significant improvement in number of attacks, headache days and quality of life, compared to modest improvement in those who used only one of the techniques.