Joshua M. Cohen, MD, MPH, FAHS
Global Medical Therapeutic Area Lead, Migraine & Headache
Migraine is often dismissed as ‘just a headache’. But the truth about this misunderstood neurological disease is a lot more painful, debilitating and isolating.
If you experience the pain and other debilitating symptoms of migraine on a regular basis, it’s easy to feel helpless and alone. “It’s an incredibly isolating disease,” says Dr Joshua Cohen, Global Medical Therapeutic Area Lead, Migraine and Headache, at pharmaceutical company, Teva.
“That’s partly because people can’t see it, so don’t necessarily know someone is experiencing pain, which is a challenge in itself. But also, because migraine patients often have to go into a dark, quiet room all alone when they’re having an attack.
“On top of that, there’s an incredible amount of stigma associated with migraine because people don’t know the difference between migraine and a headache.”
Migraine is a neurological disease related to hyperexcitability of the brain. A classic symptom is headache, while others include nausea and vomiting, plus sensitivity to light and sound.
Attacks can last for hours – or even days – and sometimes just moving can make things dramatically worse.
While a person without migraine may be able to function with a mild headache, migraine can be extremely disabling.
“Migraine can be misunderstood as ‘just a headache’,” says Dr Cohen. “But if someone can’t work, pick their kids up from school or attend social events, they’re judged as not fulfilling their obligations.”
Medications to manage the pain of migraine
Instances are common, with around one in seven people living with migraine.
“It’s believed that people may be born with a genetic predisposition towards the disease,” says Dr Cohen, “and the most prevalent age is between 25 and 55.” Blood tests and imaging can’t detect it, so clinicians reach diagnosis by studying symptoms and taking a headache history.
Thankfully, acute medications are available to help manage the pain and debilitating nature of migraine.
“Some have been available for a while, are specific to migraine and work well,” says Dr Cohen. “And new treatment options continue to emerge.”
Then there are preventive medications, which can be used in patients with frequent or disabling attacks. Older preventives were not specifically developed for migraine. Also, these drugs are often associated with side-effects that are challenging for patients to tolerate.
“As a result, people don’t stay on them long enough to benefit from their efficacy,” says Cohen. “One study found that, while around 40% of those with migraine are eligible for preventive therapy, only around 13% are actually taking it, demonstrating that this form of treatment is under-utilised”.
Migraine has a significant societal burden
“That’s a problem, because migraine tends to worsen without treatment; so a lack of effective management means an increased likelihood of attacks increasing in frequency.”
Those with 15 headache days per month or more, where at least 8 days feature migraine symptoms, are diagnosed with chronic migraine.
“Even on the days when they don’t have a headache, these patients may be recovering from an attack or experiencing lingering symptoms,” says Dr Cohen.
“They reach a point where their whole lives are consumed by the disease.” Some have to take long periods off work or, in extreme cases, give up work altogether.
In fact, the World Health Organization has ranked migraine as the second leading cause of years lived with disability worldwide.
“Migraine also causes a significant societal burden,” says Dr Cohen. “There’s a loss of productivity because people are unable to work or, more commonly, are at work but can’t function because they’re having an attack. A European study estimated that the cost of migraine amounted to €111 billion each year”.
“If you are a migraine patient, don’t feel helpless and alone,” says Dr Cohen. See a healthcare professional and get help. And tell people about your experiences. “Anyone with a chronic disease can share their stories through platforms such as Life Effects. This will help you feel more supported and less isolated.”
UK/CPE/20/0012 Date of Preparation: June 2020
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