Does Depression, Pain Sensitivity Affect Migraine Treatment Response?
Treatment that provides rapid, consistent migraine relief may help mediate factors that promote inadequate treatment response.
VANCOUVER, British Columbia – Depression, pain sensitivity, and body mass index (BMI) are among factors that predict an inadequate treatment response in patients with episodic migraine, according to study results presented at the 2016 annual meeting of the American Academy of Neurology.
The majority of patients experiencing migraine expect symptom relief within 2 hours of acute treatment for most attacks. In order to discern treatment response in these patients, researchers led by Richard B. Lipton, MD, of the Albert Einstein College of Medicine in New York City, analyzed results from the 2006 American Migraine Prevalence and Prevention study survey database.
When asked if they were pain-free within 2 hours of receiving medication for most migraine episodes, participants who responded “never,” “rarely,” or “less than half the time” were considered to have inadequate treatment response compared to those who responded “half the time or more.” Of the 8333 respondents (mean age 47 years; 82% female) included in the analysis, 3667 (44%) achieved adequate treatment response compared with 4666 (56%) who had inadequate response.
Binary logistic regression models were used to assess sociodemographics, lifestyle characteristics, headache features, and treatment patterns that may contribute to inadequate treatment response. Among the respondents, high pain sensitivity (odds ratio [OR] 1.15; 95% confidence interval [CI], 1.11-1.20), allodynia (OR 1.49; 95% CI, 1.34-1.65), clinical depression (OR 1.45; 95% CI, 1.27-1.65), greater BMI (OR 1.09; 95% CI, 1.03-1.15), and not using preventive medication (OR 0.77; 95% CI, 0.65-0.92) predicted inadequate treatment response.
Overall, most individuals with migraine do not have an adequate response to treatment. In order to improve upon this, clinicians should assess patients for factors that may predict inadequate response and focus on prescribing medications that may improve the likelihood of rapid and consistent migraine relief.
A. Bennett: Employee of Dr Reddy's Laboratories/Promius Pharma. M. Reed: Allergan, Colucid, Dr Reddys Laboratories/Promius Pharma, Endo Pharmaceuticals, GlaxoSmithKline, Merck, National Headache Foundation. D. Buse: Allergan, American Headache Society, Zogenix, Novartis, and Vedanta Research. S. Munjal: Employee of Dr Reddy's Laboratories/Promius Pharma. K. Fanning: Allergan, Inc., Colucid, Dr Reddy's Laboratories/Promius Pharma, Endo Pharmaceuticals, GlaxoSmithKline, Merck & Co., Inc., National Headache Foundation. R. Lipton: Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol Myers Squibb, Cognimed, Colucid, Eli Lilly, eNeura Therapeutics, Merck, Dr Reddy's Laboratories/Promius Pharma, Novartis, Pfizer, TEVA, Vedanta Research, eNeura Therapeutics, Boston Scientific, Navidia, Labrys Biologics Inc, ElectroCore LLC.
Bennett A, Reed M, Buse D, Munjal S, Fanning K, Lipton R. Predictors of inadequate response to medication in episodic migraine: results from American Migraine Prevalence and Prevention Study (AMPP). Presented at: The 68th Annual Meeting of the American Academy of Neurology. April 15-21, 2016; Vancouver, British Columbia, Canada. Abstract P1.154.