RECENT STUDY SUPPORTS THE LINK BETWEEN MIGRAINES AND DEPRESSION

December 11th, 2011

Dr. Marc Siegel and Dr. David Samadi weighed in on Fox News Live this morning regarding a recent study that supports a connection between migraines and depression.  He stated, “90% of all headaches we have are migraines. It’s a very good study but we don’t know if it’s the fact that you have migraines that make you depressed… maybe your lifestyle changes, maybe it’s intractable, because you are so bothered by the headaches.  Or is there something that the migraine does to the brain that alters it and makes it more prone to depression?”

“It’s 80% more likely you’re going to get depressed if you have a migraine.  So the message for people out there is be on the lookout for depression if you get migraines,” Dr. Siegel concluded.

Dr. Samadi stated it was just an observational study, not cause and effect, nevertheless useful information.  “If you get migraines, talk to your physician because there could be signs and symptoms of hidden depression.”  The doctor can then discover the depression and treat both the depression and the migraines with medication at the same time he suggested.

Two things should be noted about this morning’s news cast commentary.

First of all 90% of all headaches are not migraines.  There are two types of headaches, primary and secondary.  90% of all headaches are known to be “Primary Headaches,” whose subcategories include tension-type headaches, cluster headaches and migraines, tension –type being the most common.

Primary headaches are merely headaches that are not caused by underlying medical conditions while secondary headaches are the end result of some other medical condition such as inflammatory headaches due to a brain tumor, infection, or trauma.

Secondly, I wanted to suggest that any migraine sufferers considering prescription drug treatment for both their migraines and depression should be aware of a possible danger known as “Seratonin Syndrome” which I’ll explain at the end of this article.

The study referred to by Fox News was a recent Canadian study that concluded that people who get painful migraine headaches may be at a higher risk for developing clinical depression.

According to Reuters Health, Dr. Peter Goadsby, professor of neurology and director of the Headache Center at the University of California, San Francisco, said research linking depression and migraine headaches goes back several decades. He called the study a “useful contribution” to existing research.

Geeta Modgill, lead author of the study and her group gathered data from the Canadian National Population Health Survey, which profiled over 15,000 people and followed up with them every two years between 1994 and 2007.

Overall, about 15 percent of the people in the study experienced depression and about 12 percent experienced migraines throughout the 12 years of the study.

Cases of depression were significantly more common among people who had migraines at the beginning of the study – 22 percent of migraine sufferers got depressed, versus 14.6 percent of those who didn’t have migraines.

That made participants with migraines 80 percent more likely than people without the headaches to develop depression, and the link held up after adjusting for other influences like age and sex.

People with depression were also 40 percent more likely to develop migraines than the non-depressed.  The association disappeared when the data were adjusted for stress and childhood trauma, however.

The study also cannot determine cause and effect for the link seen between depression and migraine.

The research, published in the journal Headache, also implies that the relationship may go both ways, and people with clinical depression could have a higher risk of developing migraines.  The researchers conclude that the finding could have been due to chance.

Despite no evident mechanism, Modgill said, “Something is going on here.”

Migraine and depression sufferers should know the signs of both ailments since each might be at a higher risk for the other condition.

WHAT IS A MIGRAINE?

The frequency and intensity of migraines can vary among sufferers but commonly is characterized by

  • a throbbing headache often localized to one side of the head.
  • intense head pain usually gradual in onset, then progressively more painful.
  • sometimes accompanied by a pronounced sensitivity to light and sound or nausea and vomiting.
  • a dull, deep and steady pain or throbbing and pulsating if severe
  • can occur any time of the day, through it often starts in the morning.
  • pain in the temples or behind one eye or ear, although any part of the head can be involved.
  • may be accompanied by a variety of sensory warning signs or symptoms, such as flashes of light, blind spots, temporary loss of vision or tingling in your hand or face (MIGRAINE WITH AURA)
  • pain lasting a few hours or up to one or two days,
  • occurrence varies – once or twice a week, or only once or twice a year.

 

WHAT IS DEPRESSION?

According to the DSM-IV, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following nine symptoms at the same time:

  • a depressed mood during most of the day, particularly in the morning
  • fatigue or loss of energy almost every day
  • feelings of worthlessness or guilt almost every day
  • impaired concentration, indecisiveness
  • insomnia or hypersomnia (excessive sleeping) almost every day
  • markedly diminished interest or pleasure in almost all activities nearly every day
  • recurring thoughts of death or suicide (not just fearing death)
  • a sense of restlessness — known as psychomotor agitation — or being slowed down – retardation
  • significant weight-loss or gain (a change of more than 5% of body weight in a month)

 

Because of the migraine-depression connection, I wanted to bring up a topic I covered in an earlier MigreLief Blog Post – the danger migraineurs face when attempting to treat both depression and migraine headaches at the same time with prescription drugs.

WARNING:  ANTI-DEPRESSANTS AND MIGRAINE DRUGS –
POSSIBLY A LETHAL COMBINATION!

Migraine sufferers should be aware of the dangers of combining some anti-depressants with prescription migraine medications.  Unfortunately, the mechanism of action of many antidepressants is to increase serotonin (a feel good neurotransmitter) levels in the brain. Triptan drugs like Imitrex, which are used to reduce or end the pain of a migraine attack also work by stimulating serotonin receptors.

This combination of antidepressants and triptan migraine drugs, can lead to too much serotonin in the brain. This is not a good thing and can result in a potentially life-threatening condition known as “serotonin syndrome.”

In some people, just the use of triptans drugs such as Imitrex or Zomig alone can result in unhealthy levels of serotonin, leading to serotonin syndrome. This risk increases substantially if these people are also taking an antidepressant like Pristiq or any other of several antidepressants known either as SSRI (selective serotonin reuptake inhibitors) or SNRI (serotonin-noradrenaline reuptake inhibitors).

The symptoms of “Serotonin Syndrome” are:

Rapid heart rate and high blood pressure
Agitation or restlessness
Confusion
Dilated pupils
Loss of muscle control or twitching muscles
Heavy sweating
Diarrhea
Headache
Goose bumps
Shivering

In severe cases of serotonin syndrome life-threatening symptoms can occur:

High Fever
Seizures
Irregular heart beat
Unconsciousness

If you and your physician decide to use this combination of drugs, you must be monitored very closely for any of these signs and symptoms of serotonin syndrome.

If your migraines are bad enough, your physician may decide to stop the antidepressant so that you can use the triptan drugs with less risk (though as mentioned above, they alone, in some users can cause serotonin syndrome).

A win-win solution for many migraine sufferers who are also suffering with depression is to switch to the all-natural migraine prevention supplement, MigreLief.  There is no additional risk of Serotonin Syndrome when using MigreLief.

Prevention is clearly the best option to a lifetime of treating the pain.

 

Curt Hendrix, M.S., C.C.N., C.N.S.