Comments on: Here We Go Again http://headachedrugs.com/patient/here-we-go-again/ A migraine patient's point of view! Fri, 05 Jun 2009 05:12:53 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: ckennon http://headachedrugs.com/patient/here-we-go-again/comment-page-1/#comment-94 ckennon Fri, 05 Jun 2009 05:12:53 +0000 http://headachedrugs.com/patient/?p=35#comment-94 Hi. I have been reading your site, on and off, for a few years. Like most people who visit your blog, I have chronic headaches. I am probably one of the most cynical people regarding the treatment of chronic headaches and I honestly do not think patients with intractable headaches are well served at all. So much of the information provided by doctors and faithfully repeated by reporters and respectful patients is poorly founded. In fact, with the exception of clinical trials for the leading acute care meds, particularly triptans, much of the advice and recommendations are based on little more than opinion. There is no doubt that most headache specialists are opinionated and tend to have a strong anti-opioid bias. I noticed that concern regarding medication overuse headaches was amped up at the same time that opioids started to be recommended for non malignant pain. Many headache specialists proclaim support for pain sufferers and even the use of opioids. They are careful to point out however, that headaches are an exception because of the risk of rebound. How convenient. Everyone else seems to buy this crap. I am not saying that people should take huge amounts of medicines for headaches or that frequent medication use for headaches is not problematic. I do think, however, that we are a long way from understanding the pathophysiology of chronic headaches and the true cause and effect relationship between chronic headaches and chronic medication use. What I have real problems with is how easily headache specialists accept leaving their patients in pain based on a poorly understood diagnosis. But thank you for your consistently intelligent blog. Keep up the good work. Carol Kennon Hi. I have been reading your site, on and off, for a few years. Like most people who visit your blog, I have chronic headaches. I am probably one of the most cynical people regarding the treatment of chronic headaches and I honestly do not think patients with intractable headaches are well served at all. So much of the information provided by doctors and faithfully repeated by reporters and respectful patients is poorly founded. In fact, with the exception of clinical trials for the leading acute care meds, particularly triptans, much of the advice and recommendations are based on little more than opinion. There is no doubt that most headache specialists are opinionated and tend to have a strong anti-opioid bias.

I noticed that concern regarding medication overuse headaches was amped up at the same time that opioids started to be recommended for non malignant pain. Many headache specialists proclaim support for pain sufferers and even the use of opioids. They are careful to point out however, that headaches are an exception because of the risk of rebound. How convenient. Everyone else seems to buy this crap.

I am not saying that people should take huge amounts of medicines for headaches or that frequent medication use for headaches is not problematic. I do think, however, that we are a long way from understanding the pathophysiology of chronic headaches and the true cause and effect relationship between chronic headaches and chronic medication use. What I have real problems with is how easily headache specialists accept leaving their patients in pain based on a poorly understood diagnosis.

But thank you for your consistently intelligent blog. Keep up the good work.

Carol Kennon

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