Nearly half of all depressed patients in a recent study
also had migraines -- a rate two and one-half times higher than that
seen in those who did not have migraine.
The research was conducted by Gary E. Ruoff, MD, clinical professor
of family practice at Michigan State University College of Medicine,
and director of clinical research at Westside Family Medical Center
in Kalamazoo, and presented at the second annual Headache Research
Summit of the National Headache Foundation. After being diagnosed
with depression, subjects were queried about migraine and other
Comorbidities.
Of 107 depressed patients, 52 also had migraine -- a percentage
twice as high as expected based on previous research (Neurology
2000;54:308-313). Half of the subjects were being treated by a
physician, but the rest were self-treating their headache symptoms
fairly successfully with over-the-counter medications, Dr. Ruoff said.
Since most of these patients had infrequent headaches, rebound
headache had not become a problem.
Dr. Ruoff, a primary care physician, said he sees many comorbid
conditions, including myofascial pain, temporomandibular joint
syndrome and irritable bowel syndrome. "A lot of papers suggest
that if you get the migraine under control, the comorbid conditions
become controlled. My research shows you have to get the comorbid
conditions under control to get the migraine under control."
"The physician should be aware of the association between migraine
and comorbid depression and other comorbid illnesses," agreed Dr.
Arthur Elkind, head of the Elkind Headache Center in Mount Vernon,
NY. "The physician has to carefully question the patient who has
migraine and seems depressed...A patient with irritable bowel
syndrome who goes to a doctor with a headache may not mention
[the headache]."
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