PTSD common in migraine sufferers

Adults who suffer migraine headaches are more apt to have post-traumatic stress disorder (PTSD) than the general population, a new study suggests. And having PTSD and migraine may lead to greater headache-related disability.

"Taken together, our findings suggest that identification and treatment of PTSD in migraine sufferers is an important and potentially modifiable part of their care that may reduce migraine-related disability," Dr. B. Lee Peterlin and colleagues conclude.

Among a group of 593 adults with migraine, PTSD was present in roughly 30 percent of those who suffered chronic daily headaches and about 22 percent of those with "episodic" migraine headaches. By comparison, approximately 8 percent of the population is estimated to have PTSD.

Physical or sexual abuse was reported by about 42 percent of all migraine patients and by 65 percent of migraine patients with PTSD.

"Despite the clinical perception that military combat is the most common (cause), the most common causes of PTSD are interpersonal traumas, including sexual abuse, Peterlin, director of the Drexel University College of Medicine Headache Clinic in Philadelphia, told Reuters Health. In women, the lifetime prevalence of PTSD is twice that of men, the researcher added.

"The implications are such that abuse causes not just psychological distress from PTSD but also physical pain such as migraine," Peterlin said, and there is an increased disability seen in those migraine sufferers with PTSD than those without PTSD.

The writer of a commentary published with the study suggests future studies evaluate how a PTSD diagnosis modifies headache treatment. "Pharmacologically," notes Dr. James L. Griffith of George Washington University, Washington, D.C., "dual action antidepressants have efficacy for both migraine and PTSD, but the serotonin-reuptake inhibitor antidepressants regarded as first-line treatments for PTSD have performed poorly for migraine prophylaxis."

- Headache, April 2009.

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