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Help for intense throbbing head pain: What’s new in migraine treatment
With Migraine and Headache Awareness Month in June, the spotlight returns to this debilitating disorder, with a newer class of oral medication helping migraine sufferers enjoy better quality of life
While migraines can come in many forms and happen to anyone, they tend to be more common in women. PHOTO: GETTY IMAGES
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Pulsating, throbbing and one-sided. That dreaded pain in your head is back and it is accompanied by an increased sensitivity to light, noise and odours. In severe cases, you may even experience nausea and vomiting.
These are commonly known as migraine headaches, with each episode lasting between four to 72 hours, certainly more than just a minor inconvenience to everyday life. This Migraine and Headache Awareness Month, the spotlight returns to this debilitating condition.
In Singapore, migraines are estimated to affect up to 10 per cent of the population, costing the city $1.04 billion in 2018. A study by Duke-NUS Medical School revealed that 80 per cent of the total estimated cost was due to a loss of productivity, while the remaining 20 per cent came in the form of healthcare costs, such as medical tests and consultations.
Pfizer MISP (Malaysia, Indonesia, Singapore, Philippines) cluster primary care medical lead Sharlini T Surendran says migraines can often be debilitating. She explains: “In our focus group discussion, one of the participants, Nicole, shared that she would ‘curl up in a chair, unable to move for over four hours’. She became non-functional, spending the entire day in bed. Even sitting up was painful and lying down made sleep impossible.”
Nicole was not the only one to report crippling discomfort. Another migraine sufferer, Raynold, says he started experiencing symptoms when he was just 10 years old. “Against my better judgement, I would usually ignore it and pass it off as a minor headache,” he says. However, by the time he turned 19, the pain had peaked, often lasting for as long as two days straight.
Easing the pain
Stories like Nicole’s and Raynold’s serve as some of the key motivating factors to bring novel treatments to patients suffering from the illness.
There are currently both preventive and acute treatments available for migraine patients. These include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain; triptans, which are a type of medication that target specific neurotransmitters involved in the development of migraine attacks; as well as beta-blockers and anticonvulsants to stabilise the excitability of brain cells.
In more recent times, a newer class of medication, known as calcitonin gene-related peptide (CGRP) inhibitors, was developed as targeted therapy for migraine prevention. CGRP inhibitors can help to diminish migraine frequency and medication usage. They are effective in relieving migraines with or without aura, episodic variants, chronic versions, and medication-overuse headaches. Research shows that approximately 38 per cent of migraine patients would benefit from preventive medicine. However, less than 13 per cent use such treatment.
Managing migraines
Although migraines can come in different forms and can happen to anyone, they tend to be more common in adult women. Genetics also play a significant role as those with a family history of migraines are more likely to also suffer from the illness. Some common triggers include stress, alcohol, hormones, changes in sleep patterns, weather changes, and diet.
To manage a migraine episode, it helps to find a calm environment and turn off the lights. You may also wish to try applying hot or cold compresses to your head and neck. Massaging your scalp and applying pressure to your temples in a circular motion may also help.
Keep a journal to note when each episode started and how long it lasted. You should also take note of what you ate and drank over the last 24 hours and how much sleep you had the previous night. Noting what helped to provide relief may also be useful for future reference when you have to cope with another episode. Should migraine episodes persist or escalate, please consult a healthcare professional for treatments.
The way forward
Dr Sharlini also manages medical affairs for the company’s primary care business unit in the region, analysing and looking at patients’ health experiences to make them better.
The graduate of Melaka Manipal Medical College developed a deep interest in patient care during her time in the paediatrics department and later discovered she could help more patients by going into the pharmaceutical industry.
“While doctors prescribe treatments and medicines to patients, it is the pharmaceutical physicians who work to understand the gaps in treatment, development of new treatments, and educating doctors on the benefits and safety of these treatments,” says Dr Sharlini. “From playing a supporting role to doctors, it has evolved into becoming strategic partners for medical practitioners, working towards better patient care.”
While many Singaporeans will know Pfizer from its Covid-19 vaccine, Dr Sharlini says the company is also developing other vaccines. “Adding on to our portfolio, we also launched our pneumococcal conjugate vaccine early last year, which offers broader protection against pneumococcal disease,” she explains.
Take a migraine risk assessment quiz here to help you determine your next step in getting treatment.
References available upon request. Pfizer Private Limited, 80 Pasir Panjang Road, #16-81/82, Mapletree Business City, Singapore 117372. Tel: (65) 6403 8888 Fax: (65) 6403 8868
Co. Req. No.: 196400192M [PP-NNT-SGP-0156/04JUN2024]
Co. Req. No.: 196400192M [PP-NNT-SGP-0156/04JUN2024]
