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Q: Migraine Treatments & Bipolar
Greetings,
I was wondering if you had come across any research involving the use of
seratonin altering drugs in therapies for illnesses such as migraine, bringing
on bi-polar disorder or making it manifest itself in an individual that was
perhaps genetically predisposed to the disease in the first place?
Dear Patricia --
I presume you mean medications like the "triptans" -- sumatriptan (Imitrex) and
the like. Let's see: since I haven't heard of this, we start with a PUB MED
search...
Searching "sumatriptan bipolar disorder" yields only
some interesting research using the serotonergic agent as a "probe" into the
serotonergic aspects of the illness, some of which are presumed to be shared
with the way migraines are caused as well (what's that? not clear, that's what
they're studying).
Searching "migraine treatment bipolar", still not much
to go on to answer your question. One report on patients with bipolar disorder
found that nearly half the women (44%) had migraines. In the entire group, 27%
of them used triptans. So, if there was a really clear reaction, e.g. a
negative one such as you ask about, there are a lot of people out there using
triptans in bipolar disorder. Therefore we might reason that if such a reaction
occurs, it is uncommon or subtle -- but it would be much better to reach this
conclusion through more deliberate research. As you may know, even the
antidepressants are being examined for the possibility that they might cause a
serious reaction (namely, make people suicidal) and though you'd think that
would be pretty easy to spot (big reaction, huge numbers of individuals using
the medications), it remains unclear if such a reaction exists. So, the point
of that was, it may be a long time before we could tell you "no, no problem";
but at present, there is little evidence, at least that I know of or could find
with a brief search, linking triptans and worsening of an underlying bipolar
tendency.
However, I could easily be missing some such evidence,
so if somebody wants to enlighten me (evidence , not anecdote),
write please.
Dr. Phelps
Published November, 2004
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