Robbins Headache Clinic Blog
Herbal Studies Not Turning Out So Well
A spate of recent double blinded, controlled trials for herbal therapies have, unfortunately, not turned out so well. A large European study, of over 600 patients, concluded that Feverfew was only mildly, if at all, effective for headache. Gingko was in the news...
Abortives For Cluster Headache
The main abortives for clusters remain: triptans (Imitrex, Maxalt, etc.), oxygen analgesics lidocaine nasal spray ergots. Triptans do work the best, particularly Imitrex injections (many cluster sufferers get by with 2 or 3mg, which is half of a vial). Oxygen,...
Weather Changes and Headache
Weather changes are one of the top triggers for headache; about 40% of people with migraine feel that weather is a factor in their headaches. It is usually when a front is coming in, the pressure drops, and people state that they can 'feel it' with their head. Many...
Caffeine: How Much is Too Much
Caffeine is a 'double-edged' sword. Too much (or in some very sensitive individuals, any) will cause headaches, while some will help headaches. Caffeine is used as an 'adjunct' to certain analgesics (65mg of caffeine in Excedrin, 32mg in Anacin), enhancing the...
Irritable Bowel Syndrome in Headache Patients
As with fibromyalgia, irritable bowel syndrome (IBS) is seen in higher percentages of headache patients than in others. IBS may present with a myriad of symptoms, from constipation/diarrhea to acid reflux to gastritis. The key from a physician's standpoint is to not...
MRI..who needs one?
The question always arises as to who truly needs an MRI. With routine headaches, and no neurological symptoms or signs, the usual dictum is that scans are not absolutely necessary. However, I would never fault any physician who does a scan on all headache patients. ...
Exercise and Headache
I try and encourage people to exercise 15 or 20 minutes (at least) daily, on average. Walking, treadmill, bike, etc., even in 10 min. chunks of time, are the usual. While some people get 'exercise-induced' headaches, the majority may benefit from exercise. Even if...
Newer Triptans
Several new triptans (Imitrex-type meds) have come on the market in the past year and a half; Axert (almotriptan) came out 1.5 years ago, and more recently Frova. There are pluses and minuses to each. Axert is relatively mild, with very few chest symptoms; it is...
Weight Gain and Headache Meds
A recent study investigated this important subject; even if a headache med. works, nobody is happy if they gain 30lb. Surprisingly, Prozac topped the list of weight gainers; even more than the tricyclic nortryptylline. Depakote did, as we know, cause weight gain,...
Depakote ER 250mg
Depakote ER, Extended Release tablets, are now available in 250mg tablets, as well as 500. 500mg of the ER is approx. equal to 400 of the regular Depakote, but is longer-lasting. The 250mg tabls help with flexibility in dosing.