Education or Advertising?

Pfizer, the maker of Relpax, announced a new migraine education – and advertising – campaign today. Called "Be Stronger Than Your Migraine," the company says the campaign provides migraine patients with tools to identify how migraine affects their lives, recognize how they interfere with their own treatment and ways to have a better relationship with their doctors.

There’s not much information available on it yet, but I’ve requested the "toolkit." At the surface, it appears to be little more than a direct-to-consumer drug ad. You know the line: If you tell your doctor to prescribe Relpax, you’ll be in control and your pain will go away.

Am I being cynical? Yes. Volatile? Certainly. I’m tired of drug companies and media outlets telling me that I just have to be strong and my headaches will go away. Yes, it’s important to be assertive with your doc and to think about ways to become more involved in your treatment. It’s also important to grieve the losses that you’ve had because of your headaches. And to think critically about who is giving you such advice.

Mostly I’m angry because Pfizer, like many other drug companies, is promoting the idea of the miracle cure for migraine. Relpax might be the drug that improves migraine pain. But it isn’t going to work for everyone. It’s dangerous to believe in a miracle cure, because you’ll be crushed if it doesn’t exist for you.

This might turn out to be a great and empowering campaign and I’ll have egg on my face. I’ll share the information with you when I receive the materials. You can also look into it for yourself. Yahoo! has the press release, the campaign site has an overview and the Relpax website has more detailed information.

I have a Relpax prescription waiting for me at the pharmacy. Who knows, maybe it’ll be my miracle drug. In any case, you should know that one of the reasons I started this blog is because so much migraine information online is from advertisements thinly disguised as education campaigns. You can be sure that I’ll never push one medication or treatment over another.

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Peanut Butter & Chocolate

I don’t care if it’s a Reese’s Peanut Butter Cup or the Trader Joe’s version of this popular candy, peanut butter cookies with a Hershey’s Kiss in the middle, or a spoonful of Jif with chocolate chips stuck on top, any combination of peanut butter and chocolate is divine.

Last week I almost admitted that peanut butter and chocolate are triggers for me. Instead of accepting my fate, I say that I think that they could maybe be triggers.

I can do this because the medical jury is still out on whether foods are migraine triggers. Some believe that chocolate might be food people crave right before a migraine, but that it’s not the actual trigger. Or maybe a patient ate peanut butter and got a migraine, but stress and weather changes really triggered the headache. An ACHE newsletter article called The Trigger Quagmire explores this point of view.

Of course other articles deflate the argument, but I’m sticking with this one for right now. I’ll ignore that my husband is sure that peanut butter and chocolate are among my triggers. He doesn’t love peanut butter like I do. I’m skeptical that anyone loves peanut butter as much as I do. Add chocolate and I’m a goner.

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Migranal Spray Redesign

At last week’s American Headache Society conference, Valeant Pharmaceuticals showed a redesigned Migranal spray mechanism. The complicated assembly of the mechanism has been replaced with a vial and a ready-to-use pump. No studies have been done to see if the new delivery system changes how well or how quickly the drug works. At the very least, you’ll have less to fumble with and think about before you get some relief.

Different Causes of CDH

I tend to use chronic daily headache and migraine interchangeably because my chronic migraines are thought to have transformed into daily headaches. I’m trying to stop doing this, though, because migraine is not the only instigator of CDH. In fact, the International Headache Society has identified 24 different causes for it.

American Family Physician published an article in December 2004 that describes these causes in the US and Europe. In 53% of cases, CDH begins from chronic tension-type headaches. Another 31% are chronic migraines that have transformed into daily headaches. In both type, the headaches gradually change from being distinct events to constant. Another common cause with a gradual onset is medication overuse, a.k.a. rebound headaches.

For the majority of those with CDH, one or more of the above classifications will fit. But for others, CDH may be brought on suddenly by head or neck trauma, flu-like illness, surgery, meningitis, or some other medical illness. I don’t know much about this second set of causes and I don’t really know how they are treated. But I expect that we experience very similar things with the different types of CDH.

Marijuana’s Painkilling Compounds

I’m not ready to jump into the debate about medical marijuana, but there’s no denying it’s been big news lately. WebMD and USA Today both published articles yesterday that address components of marijuana that may control pain.

Botox Study Details

Allergan has released details of its Phase II Botox study, the findings of which researchers presented at today’s AHS conference.

Based on these findings, the FDA has approved Allergan to progress to the Phase III study. This study, scheduled to begin late this year, will investigate how safe and effective Botox is for migraine patients with chronic daily headache.

AHS’s Annual Meeting Underway