Physician Articles

by C. Philip O’Carroll, M.D. INTRODUCTION: Let us begin first by defining the word analgesia. It comes from two Greek words, ‘an’ meaning not and ‘algesia’ meaning pain. The term analgesic therefore is a fancy term for “pain killer.” In our society we have been educated, both physician and general population alike, to think of disease or discomfort in a strictly “medical model fashion.” According

TRICYCLIC ANTIDEPRESSANTS (TCAs) Antidepressants, particularly the tricyclic antidepressants, are widely used in the prophylaxis of migraine and tension-type headache. Amitriptyline (Elavil), in dosages ranging from 10 to 200 mg. a day, is probably the most commonly used TCA. Other drugs are also used. MECHANISM OF ACTION The biological basis for its mechanism of action includes “turning off” the generators in the brain stem which create

In recent years, there has been a growing awareness that certain types of anti-seizure medicines or anti-epilepsy drugs (AEDs) may help in reducing migraine frequency and severity. Depakote is now approved for three indications, including epilepsy, migraine, and manic-depression. In cases of chronic headache where mood fluctuations are complicating the clinical picture, Depakote may be extremely valuable. In scenarios where beta blockers and calcium channel

Of all the preventative medicines available across the United States, the drugs known as beta blockers are probably the most frequently prescribed. The “beta” refers to receptors on the blood vessels known as beta receptors. Beta blockers prevent the chemical interaction of certain chemicals with this receptor, hence, the term “beta blockers.” Of this family of drugs, the most frequently used drug is Inderal, although

Calcium channel blockers have assumed a significant role in the prevention of migraine and cluster headaches. MECHANISM OF ACTION The beneficial effects of these agents are attributed to their ability to inhibit the movement of calcium ions across the cell membranes. This prevents mechanical contraction of the muscle wall of the artery. There are several chemically distinct classes of compounds which share the ability to

by C. Philip O’Carroll, M.D. The following is Dr. Lee Kudrow’s personal account of a cluster headache, perhaps one of the most harrowing examples of pain that a human being can suffer. Few pains can incite such feelings of rage, panic and thoughts of self-destruction. Following a period of perhaps several hours, during which I feel quite elated and energetic, I experience a fullness in

Cholinesterase inhibitors: Aricept, Exelon, Razadyne Cholinesterase inhibitors (AchEI) increase the amount of acetylcholine in the brain, in an effort to compensate for loss of nerve cells that normally produce this messenger molecule. There are three AchEI’s on the market – Aricept, Exelon and Razadyne and they are approved to treat mild to moderate Alzheimer’s disease (AD). Aricept recently received FDA approval to treat severe AD. Clinical

Is it the first sign of Alzheimer’s Disease or just memory loss? Public awareness of Alzheimer’s Disease (AD) is reaching new heights and treatment is most effective in the mild stages of disease. Therefore, there is great emphasis on diagnosing AD in its earliest stages. Most are aware that the first symptom of AD of often a slow gradual impairment of memory. Not all memory

INTRODUCTION Migraine is a severe episodic headache that affects about five percent of men and about fifteen to seventeen percent of women. Over eighty percent of these people suffer some degree of headache-related disability. In the United States, the estimated annual cost, including costs of direct medical care and lost productivity, exceeds seventeen billion dollars annually. We know that the disorder is at least four

NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDs)Naproxen, ibuprofen, and other NSAIDs have been tried for migraine prevention. Their clinical efficacy is not as good as beta blockers, valproate, or calcium channel blockers. The potential side effects, such as stomach upset, make them inappropriate for long-term therapy. However, for short-term or “mini-prophylaxis,” particularly for menstrual migraine, agents such as naproxen sodium (Naprosyn), may be very effective. MAGNESIUMEven though magnesium

There are a number of modifiable risk factors for memory loss and Alzheimer’s disease (AD). You can be proactive and reduce your risk by: Taking control of your blood pressure Studies demonstrate that mid-life high blood pressure leads to poor brain function later in life. To lower your blood pressure: Lower the amount of salt in your diet – try not to add extra salt

INTRODUCTION Too much of a good thing can be a real “headache” for migraine sufferers. Analgesics (pain killers) are designed to relieve pain. But if these drugs, both prescription and non-prescription, are overused, they can actually cause headache. This is known as “rebound headache syndrome” or more simply “rebound headache.” Rebound headache can result when people become dependent on analgesics. This can happen with over-the-counter

BREAKING THE CYCLE The first step toward breaking the analgesic rebound cycle is to talk about it with the physician. Many patients ignore the fact that they are taking over-the-counter medicines; they feel that somehow these are not “real drugs.” Be absolutely honest with the doctor. Many people underestimate the quantity of medication they are taking. Make sure that your doctor knows what medicines you