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Migraine treatment ‘lagging'
Migraine treatment ‘lagging'

Otago Daily Times

time11-06-2025

  • Health
  • Otago Daily Times

Migraine treatment ‘lagging'

University of Otago public health senior research fellow and Migraine Foundation co-founder Dr Fiona Imlach says New Zealand is lagging behind other countries when it comes to treating migraines. PHOTO: SUPPLIED When it comes to funding and accessing migraine prevention medication and other therapies, New Zealand is "lagging behind" other countries. University of Otago (Wellington) researchers examined the use of supplements and complementary therapies by 530 Kiwis with migraine disease, and found about half of them turned to treatments other than medication in an attempt to ease their symptoms. The participants were asked about supplements such as magnesium, riboflavin (vitamin B2) and coenzyme Q10 and complementary therapies including acupuncture, biofeedback, neuromodulation devices, meditation, yoga and massage. Study co-author, public health senior research fellow and Migraine Foundation co-founder Dr Fiona Imlach, said many people with migraine did not take medication to prevent migraine attacks, but non-pharmacological approaches could help. "No previous research has looked at the use of these approaches in Aotearoa, so it's a new finding that about half of the 530 survey respondents were currently using a supplement, and even more, 58%, were using complementary therapy." Although most non-pharmacological treatments were considered safe or low risk, the quality of evidence for their effectiveness could be low, Dr Imlach said. The survey focused on treatments that were included in international guidelines on migraine management, including those not easily accessed in New Zealand such as neuromodulation devices, which worked by stimulating nerves in order to change the way pain signals in the brain were processed. However, access to neuromodulation devices was limited and costly and previous distributors had pulled out of the New Zealand market, Dr Imlach said. PHOTO: GETTY IMAGES "Neuromodulation devices and other therapies could be beneficial for both patients and for workplaces, by decreasing the number of days people are affected by migraine, improving quality of life and people's ability to work. "These approaches can also be a good option for people who can't or don't want to take medication, such as during pregnancy. "So even though people said they would like to try non-medication treatments as part of their migraine management plan, they can be expensive and hard to find information about," she said. The survey also confirmed there was no single approach to migraine prevention that was universally effective, so people had to use trial and error in the hope of finding relief. "For all of the treatments we asked about, there were many people who had tried them, but they didn't work or had side effects. "There were also those who hadn't tried them before but wanted to. "All of this speaks to the huge need for more effective migraine treatments, both medication and non-medication. "New Zealand is lagging behind other countries with regards to funding and access to migraine-prevention medication and other therapies."

No single approach to migraine prevention is effective
No single approach to migraine prevention is effective

RNZ News

time10-06-2025

  • Health
  • RNZ News

No single approach to migraine prevention is effective

science health about 1 hour ago Around half of people with migraine disease turn to non-medication treatments to ease their symptoms, new research has revealed. The Migraine in Aotearoa New Zealand survey from University of Otago researchers asked participants about supplements and treatments they've used including magnesium and vitamin B2 or meditation, yoga and massage. Dr Fiona Imlach is an epidemiologist at the Department of Public Health at the University of Otago and founder of charity Migraine Foundation Aotearoa New Zealand. She says there is no one-size-fits-all approach to migraine treatment and that while there are some treatments out there that are not recommended, many non-pharmacological approaches can actually help - they just aren't available here.

The McMigraine hack: does it really work?
The McMigraine hack: does it really work?

RNZ News

time08-06-2025

  • Health
  • RNZ News

The McMigraine hack: does it really work?

For people living with migraine disease it can be a debilitating condition that is invisible to others. In New Zealand, 753,000 people live with migraine, affecting three times as many women than men. Dr Fiona Imlach has lived with migraine for many years, and frustrated by the lack of migraine specific care, she co-founded Migraine Foundation Aotearoa New Zealand in 2022. Dr Imlach joins Jim to discuss migraine disease, its causes, and what can help. Photo: 123RF

The McMigraine meal hack: Does it actually work?
The McMigraine meal hack: Does it actually work?

RNZ News

time08-06-2025

  • Health
  • RNZ News

The McMigraine meal hack: Does it actually work?

A 'migraine brain' is sensitive to sensory input. Photo: Quin Tauetau / RNZ Epidemiologist Dr Fiona Imlach has lived with migraines for many years. Now, as co-founder of Migraine Foundation Aotearoa New Zealand, she has also spent many years researching them. Imlach told Sunday Morning's Jim Mora a TikTok video suggesting a 'McMigraine Meal' - a bottle of Coke and a side of salty fries - as a treatment might not be totally far-fetched. "TikTok's not really the font of all wisdom but there is some element in this in terms of the cola, has caffeine in it, and we know that caffeine can be quite an effective migraine treatment." However, she said medication with caffeine in it could be a problem if over-used. An alternative was to limit caffeine intake to one or two cups of coffee per day and take it at the same time each day because the migraine brain "likes routine". A sugar hit could also help Imlach said, because there was a theory that a migraine attack was triggered by nerves in the brain being depleted of glucose. On the salty fries, Imlach said food cravings were much stronger during the prodrome phase causing people to think the food they ate triggered the attack when actually it was already underway. Salt was not known to help treat an attack, she said. A TikTok video claims a McDonald's coke and fries can help a migraine. Photo: AFP Imlach told Mora there was a lot of mystery surrounding migraines. In the past migraines had been treated as a vascular disease and thought of as an allergic disease with certain triggers, but Imlach said it was very much recognised as a neurological disease. She said migraine was a genetically-determined condition and some people inherited a pre-disposition through one of their parents. A person who suffered migraines was thought to have a "sensitive" brain, or a hyperactivity toward sensory input, and it did not react the way it normally would, she said. "That triggers all these other things you get with a migraine attack. Often people think about headache pain but also things like being sensitive to light and sound." Those symptoms, along with nausea, fatigue and mood disturbances were a brain disturbance caused by the sensitivities, and could be painful and unpleasant, she said. Migraine was a disease of the brain which was present all the time but symptoms were only triggered during an attack. When the attack was over, the migraine tendency didn't go away. Imlach said a classic migraine started with sufferers "feeling a bit rotten" in the "premonitory" stage, which preceded the attack. This was a stage people hadn't recognised very well in the past. For Imlach, she suffered cognitive difficulties during this phase - being unable to speak properly. The premonitory or prodrome phase could last up to two days according to brain scans of some patients. "So you're going about your life, you haven't got a headache, you think you're fine but actually your migraine attack has started." These early symptoms included difficulty concentrating, fatigue, and mild head pain and that could be a warning sign. A full blown attack involved other symptoms including a visual aura. "I used to get spots in my vision, which I couldn't see, or I'd get flashing lights. "And then you move on to the headache phase and that can last for a few hours to a few days. "Quite a severe pain. Usually on one side of the head - for me it was on one side of the head - sometimes it would move to the other side of the head for a while." Neck pain, nausea and vomiting were also common for Imlach who said while light sensitivity was common for many, she was highly sensitive to sound during an attack. "Even someone speaking to me can feel really painful and echo in my head and also I get sensitive to smells so smells can be really unpleasant. "Even someone's deodorant can make me want to vomit." Migraine prevalence was two to three times higher in women than men. "The hormone is probably the most common trigger. So women who have migraines will have a hormonal triggering element to that." This became obvious around puberty, while after menopause migraines could improve. There were two types of treatment for migraine - acute and prevention. The best available treatments for an attack was migraine-specific medication called triptans, as well as over-the-counter medicines. For frequent and severe attacks, Imlach said a preventative treatment should be considered to "calm the brain down". "Traditionally all we've had is treatments that have been repurposed from other conditions. "So we've had anti-depressants which people have taken and sometimes found it helps their migraine attacks." Others found to help were beta blockers and anti-hypertension medicines as well as botox, none of which were specifically developed to prevent migraines. In the past nine years new micro-medications had been developed specifically to treat one of the neurotransmitters in the brain involved in the pain part of the migraine attack, Imlach said. "Those have been a revolution in treatment and they don't have the same side-effects - they're much more tolerated - because they've been developed with migraine in mind." Unfortunately, they were not funded, she said. "We have three available in New Zealand at the moment but they are quite expensive and they're on Pharmac's waiting list so they've been approved for funding but they're just waiting to see whether Pharmac can actually get the budget to fund them." Imlach said frequent migraine sufferers had to be careful about taking too many migraine-specific triptans and over-the-counter medicines such as non-steroidal drugs. "If you start taking too many of those you can actually make the headache worse and you can actually develop a headache." That spoke to the migraine brain's sensitivity, she said. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.

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