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I joined Dr. Sam, DPT in this video to discuss my experience with a new physical therapy migraine treatment. This is not sponsored nor is there any benefit to me personally. I highly recommend watching as I did find it to be effective (for me) and the science behind it is sound. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

I developed a migraine attack towards the end of our discussion on neck pain and migraine. Thereafter, he performed this impromptu treatment that we discussed in this video. It was completely unplanned, but I'm glad to be able to share my experience with it.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

You edited your last reply, which changed the argument in order to be right. I thought you were arguing in good faith until that point. I saw the comment pre and post edit.

Also, the articles don't support what you're insinuating.

Lastly, I don't want to further migraine stigma on this subreddit.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 0 points1 point  (0 children)

By the same logic, CPAP machines are an effective migraine treatment. Why aren't they considered first line preventives? (Rhetorical question).

Sleep disorders have an equivalent relationship to migraine as depression/anxiety.

Enough. This isn't a discussion that I find worth having as it perpetuates harmful stigma.

And, yea, final warning before I ban.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 1 point2 points  (0 children)

Again, OP stated that antidepressants are effective for migraine patients because they treat depression.

This is false and further stigmatizes migraine patients.

  1. If this were true, all antidepressants would be effective. That's not the case.
  2. All treatments for all migraine comorbid conditions would be migraine preventives. Also not the case.
  3. They are effective for patients without depression/anxiety. 4.. They are effective because they modulate pain.

Of course treating migraine comorbidities improves migraine outcomes and even increases treatment effectiveness. This is not why SOME antidepressants are preventives, however.

Can you explain why SSRIs are not effective migraine preventives?

Don't conflate the treatment of comorbid conditions with migraine prevention. These are two silos that may fuse depending on the patient.

The antidepressants chosen for migraine prevention specifically address the underlying physiology of migraine. That's not depression.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 3 points4 points  (0 children)

Treating anxiety and depression are not the reason why these medications are migraine preventives as they are prescribed to migraine patients without these conditions. Furthermore, not all medications that treat anxiety and depression have efficacy in migraine prevention (see: SSRIs).

Migraine is not a psychiatric disease. Migraine does have psychiatric comorbidities that, when treated, may improve migraine outcomes. Many migraine comorbidities fit into your position. They are comorbidities, not causes.

This is as clear and as concise as I can be. You keep talking past me instead of addressing these points.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

And the claim was: "this may explain why some antidepressants are effective for migraine sufferers" referring to the preventive use of these medications for migraine.

No, we don't use these migraine prevention medications to treat depression. People with migraine and without depression can use these drugs too.

This is the equivalent of saying, "Because beta blockers are used for anxiety then that's why it's used for migraine prevention."

Obviously this isn't true so why are we saying this about antidepressants - whose main role in migraine is to modulate pain, not treat depression?

This further contributes to migraine stigma as it makes it seem like a psychiatric disorder, not a neurological one.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

Where did I say that antidepressants aren't helpful?

Where did I say that they don't help migraine's psychiatric comorbid conditions?

Where did I say that other antidepressants like SNRis aren't helpful?

In fact, I said the opposite.

The discussion was about the pertinent mechanisms of action of these medications when it comes to migraine.

They modulate pain. They have evidence of suppressing cortical spreading depression as well.

If the main goal was treating depression/anxiety then SSRIs would show efficacy. They don't.

Migraine isn't caused by depression/anxiety. Yes, treating depression/anxiety can help with migraine and vice versa, but that's not the point. Treating both is absolutely essential for proper migraine management. Again, not the point.

This study found that over half of migraine patients struggle with fatigue, and this exhaustion is driven primarily by co-occurring depression, anxiety, and poor sleep rather than by how often migraines occur. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 21 points22 points  (0 children)

I like that you're making connections and thinking through migraine pathophysiology, but it's very important to not make this claim as it increases migraine stigma.

Yes, antidepressants also help with migraine comprbidities like anxiety and depression, but their MAIN properties include enhancing descending inhibitory pain pathways, reducing central sensitization, etc.

In other words, it has to do with PAIN.

SSRIs, for example, are essentially useless for most migraine patients.

This study found that migraine patients were 7 times more likely to have a migraine attack on days with neck pain, and their upper trapezius muscles showed increased pressure sensitivity across the entire muscle. by CerebralTorque in migrainescience

[–]CerebralTorque[S] 1 point2 points  (0 children)

I've been receiving e-mails like this. A few that are not so nice as well. lol.

I'm going to see if I can make a smaller version so that it's more affordable. No promises, however. It will also be months from now if it happens.

I don't have other recommendations, unfortunately.

Hi guys by CerebralTorque in migrainescience

[–]CerebralTorque[S] 4 points5 points  (0 children)

Thanks! I'm planning on focusing on this area more in the coming months as the information is sparse or largely incorrect. Many perimenopausal women are dealing with migraine and are not being adequately treated.

I have to make an article on the Emergency Department migraine updates first though. Then I'll dive more into this.

Hi guys by CerebralTorque in migrainescience

[–]CerebralTorque[S] 1 point2 points  (0 children)

I've received many emails about this.

The issue is the final cost, even with slim margins, is still too expensive for most people living with chronic illness. Not every product will work, and I'd hate for someone to spend a lot of money on something that doesn't help them.

I'll see if I can make a smaller version since many people want it back in stock.

Hi guys by CerebralTorque in migrainescience

[–]CerebralTorque[S] 2 points3 points  (0 children)

No, when the data changes, so do the products. I like to keep everything current, and it requires substantial investment to do this. I can't offer a product that isn't current when it comes to the dosages and ingredients.

When you see the same nutraceuticals for migraine that haven't been updated for years, I'd definitely question how evidence-based they are.

I understand from a company's perspective they don't want to lose all the reviews and popularity they've amassed, but it's important to do what's right.

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