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Migraines

Current estimates of migraine sufferers in the United States vary from 28,000,000 to 30,000,000 individuals with a large preponderance of females until later in life when the ratio tends to be even. The direct costs associated with this condition, i.e. inpatient and outpatient care, prescription costs, etc. exceed $11 billion annually, and indirect costs due to disability are in excess of this number. Unfortunately, existing treatment regimens are only partially or variably effective as witnessed by the large number of remedies available, as well as the even larger number of supplemental or adjunctive drugs often used in this condition.

Even the underlying pathophysiology is not agreed upon. Some sources point to studies that speak to cortical (cognitive brain) depression and others speak to cortical hyper-excitation. Even though the older theories of blood vessel narrowing (vasoconstriction) followed by blood vessel expansion (vasodilatation) are not now in vogue, the consequences of vasodilatation are still very much in evidence as the inciting factors producing the migraine syndrome. The seeping of fluid into surrounding tissues which contain chemical substances that directly stimulate nerve pain fibers is well established as accurately describing the physical state of the areas directly producing migraine. This is invariably accompanied by local inflammation That the entire syndrome is stress related is also generally agreed upon, although the proximate trigger stimuli are extremely varied.

Even though there is a fair amount of variability and individualization in the treatment regimens for migraine, the triad of anti inflammatory pharmaceuticals, vasoconstrictors, and analgesics are part of most therapies. Early treatment with acetaminophen (Tylenol) and NSAIDS (Ibuprofen, Naproxen) is usually recommended, followed by vasoconstrictors (Ergotamine, Tryptans; e.g. Imitrex, etc.) and for intractable pain, analgesics, including opioid narcotics. A recently available combination of naproxen and tryptan, Treximet, seems to give the best overall results, although this medication is quite costly. Under the best of circumstance, no treatment regimen seems to offer relief to more than 50-67% of migraine sufferers, and of those that are afforded some or complete relief less than 25% are pain free 24 hours after onset of the pain.

We are now making available a topical adjunctive pain reliever, bluMjk, which apparently alleviates pain by a direct suppressive effect on the nerves that transmit the sensation of pain. The effect is usually seen in minutes, the ingredients are without any habituating or addictive possibilities, there is no known toxicity, and it can be applied every 4-6 hours as needed. Application, as with other medications, will be most effective when used closer to the time of onset of the pain, but we have never not seen bluMjk reduce the intensity of the migraine when used according to instruction, no matter when in the course of the syndrome it was applied. One 9 ml. vial, when used to cover the entire painful area involved, including that area within the hairline, will last for a minimum of 20 applications. We urge all migraine sufferers to add bluMjk to their treatment regimen.

Results. Patients with migraine (n = 215,209) had significantly higher average health-care expenditures compared with matched controls ($7007 vs $4436 per person per year; difference of $2571; P < .001). Migraine-associated national expenditure estimates: outpatient care, $5.21 billion; prescriptions, $4.61 billion; inpatient care, $0.73 billion; and emergency department care, $0.52 billion.

Conclusions. The direct costs associated with patients with migraine were found to be $2,571 per person per year higher than in matched nonmigraine controls. The projected national burden of migraine of $11.07 billion is substantially higher than previous estimates.

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