Updated April 24, 2015.

July, 2000. In my last feature, I quoted Dr. Stephen Silberstein of the U.S. Headache Consortium:

• "Migraine, we used to believe, was a disorder of anxious, neurotic women whose blood vessels overreacted. Migraine is not that. Migraine is a neurobiological disorder of the brain."
  

That was good news indeed for all of us Migraineurs. Coinciding with that good news, came the release of more immediately applicable news:

• "Guidelines for Fighting Migraines"

The U.S. Headache Consortium includes the American Headache Society, the National Headache Foundation, the American College of Emergency Physicians, the American Academy of Family Physicians, and other medical groups. For more than three years, this group of scientists has been working to formulate guidelines for both patients and the physicians who treat them for headaches.

According to Dr. Silberstein, the patient guidelines are, "designed to help patients be their own advocates in seeking care." The guidelines for physicians, "include assigning a grade to tell all of the medications available and are designed to help physicians best treat their patients with Migraine.

For Migraine sufferers, the Consortium recommends:

• Become aware of how often headaches occur as well as the factors that trigger them.
  
• Avoid triggers once you identify them.
  
• Locate an understanding physician, experienced in treating headache, who is willing to work with you to achieve the best treatment.
  

• Inform your doctor of the extent to which the headaches affect your daily life. (A headache diary is an excellent tool for this.)
  
• Treat Migraines with the appropriate medications -- over-the-counter for less severe attacks, prescription drugs for moderate to severe Migraines.
  
• Use headache medications in moderation. Many of them can cause rebound headaches if taken too frequently. Be aware of the potential for rebound with each medication you take.
  
• Keep a "rescue" medication on hand in case your regular medication doesn't work.
  
• Find the treatment that works for you. If a medication doesn't work for you after three subsequent Migraine episodes, ask your doctor to prescribe a different medication.
  
• Consider discussing with your physician preventative drugs for recurrent headaches.
  
• Consider alternative therapies such as relaxation techniques or biofeedback if you are unable to used medications or are opposed to taking medications.
  

The guidelines for physicians address five key Migraine management areas: diagnosis, acute treatment, prevention, drug therapy, and behavioral therapies. 

Dr. Eric Wall, a Consortium member representing the American Academy of Family Physicians, explained, 

• "The main thrust of the guidelines is to help physicians think out an overall management plan that is tailored to the individual. A systematic approach to Migraine management has been lacking until now ... The patient plays a big role in treatment, and this aspect of therapy is integrated throughout the guidelines ... If you don't feel you're included in your care, find a doctor who will listen and help you get involved."
  

Dr. Silberstein commented, 

• "We believe pain begets pain. So nipping it in the bud can only be helpful down the road ... If you're not getting adequate therapy or care, then get a new doctor."
  

For those who have struggled with Migraine, it seems that change is at hand. These guidelines and the underlying research come as a validation of sorts. People who have been understanding and helpful are now proven to be on the right track. Those who have thought Migraines were "just a headache" may now look to current research and these guidelines to provide them with correct information.

Following the patient guidelines and taking the advice of Doctors Silberstein and Wall regarding teaming up with your healthcare team will lead us to better understanding and better treatment of Migraine.

The physician guidelines are steeped in medical terminology, but contain a wealth of information. The five sections may be accessed through these links:

• Overview of Program Description and Methodology
• Neuroimaging in Patients with Nonacute Headache
• Pharmacological Management of Acute Attacks
• Behavioral and Physical Treatments
• Pharmacological Management for Prevention of Migraine

(Adobe's Free Acrobat Reader is necessary to read the guidelines.)
U.S. Headache Consortium Releases Treatment Guidelines
July, 2000. In my last feature, I quoted Dr. Stephen Silberstein of the U.S. Headache Consortium:

• "Migraine, we used to believe, was a disorder of anxious, neurotic women whose blood vessels overreacted. Migraine is not that. Migraine is a neurobiological disorder of the brain."
  

That was good news indeed for all of us Migraineurs. Coinciding with that good news, came the release of more immediately applicable news:

• "Guidelines for Fighting Migraines"

The U.S. Headache Consortium includes the American Headache Society, the National Headache Foundation, the American College of Emergency Physicians, the American Academy of Family Physicians, and other medical groups. For more than three years, this group of scientists has been working to formulate guidelines for both patients and the physicians who treat them for headaches.

According to Dr. Silberstein, the patient guidelines are, "designed to help patients be their own advocates in seeking care." The guidelines for physicians, "include assigning a grade to tell all of the medications available and are designed to help physicians best treat their patients with Migraine.

For Migraine sufferers, the Consortium recommends:

• Become aware of how often headaches occur as well as the factors that trigger them.
  
• Avoid triggers once you identify them.
  
• Locate an understanding physician, experienced in treating headache, who is willing to work with you to achieve the best treatment.
  
• Inform your doctor of the extent to which the headaches affect your daily life. (A headache diary is an excellent tool for this.)
  
• Treat Migraines with the appropriate medications -- over-the-counter for less severe attacks, prescription drugs for moderate to severe Migraines.
  
• Use headache medications in moderation. Many of them can cause rebound headaches if taken too frequently. Be aware of the potential for rebound with each medication you take.
  
• Keep a "rescue" medication on hand in case your regular medication doesn't work.
  
• Find the treatment that works for you. If a medication doesn't work for you after three subsequent Migraine episodes, ask your doctor to prescribe a different medication.
  
• Consider discussing with your physician preventative drugs for recurrent headaches.
  
• Consider alternative therapies such as relaxation techniques or biofeedback if you are unable to used medications or are opposed to taking medications.
  

The guidelines for physicians address five key Migraine management areas: diagnosis, acute treatment, prevention, drug therapy, and behavioral therapies. 

Dr. Eric Wall, a Consortium member representing the American Academy of Family Physicians, explained, 

• "The main thrust of the guidelines is to help physicians think out an overall management plan that is tailored to the individual. A systematic approach to Migraine management has been lacking until now ... The patient plays a big role in treatment, and this aspect of therapy is integrated throughout the guidelines ... If you don't feel you're included in your care, find a doctor who will listen and help you get involved."
  

Dr. Silberstein commented, 

• "We believe pain begets pain. So nipping it in the bud can only be helpful down the road ... If you're not getting adequate therapy or care, then get a new doctor."
  

For those who have struggled with Migraine, it seems that change is at hand. These guidelines and the underlying research come as a validation of sorts. People who have been understanding and helpful are now proven to be on the right track. Those who have thought Migraines were "just a headache" may now look to current research and these guidelines to provide them with correct information.

Following the patient guidelines and taking the advice of Doctors Silberstein and Wall regarding teaming up with your healthcare team will lead us to better understanding and better treatment of Migraine.

The physician guidelines are steeped in medical terminology, but contain a wealth of information. The five sections may be accessed through these links:

• Overview of Program Description and Methodology
• Neuroimaging in Patients with Nonacute Headache
• Pharmacological Management of Acute Attacks
• Behavioral and Physical Treatments
• Pharmacological Management for Prevention of Migraine

(Adobe's Free Acrobat Reader is necessary to read the guidelines.)