Migraine and epilepsy drug Topamax is being recalled by its manufacturer, Ortho-McNeil Neurologics, a division of Johnson and Johnson. This recall affects only two lots of 100 mg tablets. This recall does not affect topiramate, generic copies of this brand. Since the generic form is much cheaper, most patients have switched to it from branded Topamax. This adds another problem to this beleaguered drug. It was recently reclassified by the FDA from pregnancy category C to category D, which means that it is much more dangerous for the fetus than originally thought. Topiramate is also associated with a high incidence of kidney stones (20%) and can cause other serious problems. This is why we always emphasize non-drug approaches (exercise, acupuncture, biofeedback magnesium, Botox, etc), which can be more effective and are much safer than drugs.
Read MoreThere are over 4 million chronic migraine sufferers in the US. Chronic migraine is defined as a headache with migrainous features, which occurs on more than 15 days each month. Many of these chronic migraine patients we see at the New York Headache Center have daily headaches. By the time they come to our Center, many have seen several doctors, including neurologists and found no relief from a variety of drugs. A new book just published by Oxford University Press may help doctors who care for headache patients to provide better care. The book is Refractory Migraine, Mechanisms and Management. Dr. Mauskop and Dr. Sun-Edelstein contributed a chapter to this book: Nonpharmacological Treatment for Refractory Migraine: Acupuncture, Vitamins and Minerals and Lifestyle Modifications. An important message contained in the chapter and the one we always stress to our patients is that the best way to approach a refractory headache is not by trying one drug after another, but by combining drugs with nonpharmacological treatments, such as biofeedback, magnesium, other supplements, Botox injections, acupuncture and other therapies.
Read MoreAcupuncture increases connections between different areas of the brain, according to Dhond and other Korean researchers who published their findings in the journal Pain. They compared the effect of true and sham acupuncture in healthy volunteers using functional MRI of the brain. They discovered that true acupuncture (insertion of one needle into the forearm) enhanced the “spacial extent of resting brain networks to include anti-nociceptive (pain-relieving), memory, and affective (responsible for emotions) brain regions”. The researchers felt that this enhancement of connections between various parts of the brain is probably responsible for the pain relief induced by acupuncture. After the recent German study of acupuncture for headaches which involved over 15,000 patients there is little doubt that acupuncture works for headaches (and many other pain conditions), but this study helps provide stronger scientific evidence that the relief is not due to placebo.
Read More15,056 patients with migraine and tension-type headaches were treated with acupuncture in a largest acupuncture study, which was financed by the German government. Results published in the latest issue of journal Cephalalgia by S. Jena and colleagues indicate that “acupuncture plus routine care in patients with headache was associated with marked clinical improvements compared with routine care alone”. This study should dispel any remaining doubt about the efficacy of acupuncture in the treatment of headaches.
Read MoreGerman researchers showed that acupuncture relieves back pain significantly better than combination of medications, physical therapy and exercise. They enrolled over one thousand patients with chronic back pain in a study that compared traditional Chinese acupuncture (where acupuncture sites selected based on pulse diagnosis and other traditional methods and needles are placed along specific meridians on the body) with sham acupuncture (needle are placed superficially and outside the traditional points) and conventional approach. It turns out that 10-15 sessions of both traditional and sham acupuncture treatments were better than conventional treatment, providing relief in 47.6%, 44.2% and 27.4% of patients respectively. This large study clearly proves the efficacy of acupuncture in back pain, regardless of the acupuncture technique. Similar results have been found in headache patients.Â
Read MoreA recent study by Richard Harris presented at the American Pain Society’s meeting of 18 patients with fibromyalgia showed different brain mechanisms for true and sham acupuncture. It appears that placebo response in sham acupuncture can be differntiated from the true acupuncture response by measuring binding properties of the mu opioid receptor in the brain. This study further confirms the fact that one of the most important mechanisms of action of acupuncture is through the endogenous opioid system and that it is different from the mechanism of the placebo effect.
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