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Study Shows Migraine Workup Worthwhile In
Patients With Depression
David Holzman
Posted: August 2005  
CNS News - July 2005

Nearly half of all depressed patients in a recent study also had migraines -- a rate two and one-half times higher than that seen in those who did not have migraine.

The research was conducted by Gary E. Ruoff, MD, clinical professor of family practice at Michigan State University College of Medicine, and director of clinical research at Westside Family Medical Center in Kalamazoo, and presented at the second annual Headache Research Summit of the National Headache Foundation. After being diagnosed with depression, subjects were queried about migraine and other Comorbidities.

Of 107 depressed patients, 52 also had migraine -- a percentage twice as high as expected based on previous research (Neurology 2000;54:308-313). Half of the subjects were being treated by a physician, but the rest were self-treating their headache symptoms fairly successfully with over-the-counter medications, Dr. Ruoff said. Since most of these patients had infrequent headaches, rebound headache had not become a problem.

Dr. Ruoff, a primary care physician, said he sees many comorbid conditions, including myofascial pain, temporomandibular joint syndrome and irritable bowel syndrome. "A lot of papers suggest that if you get the migraine under control, the comorbid conditions become controlled. My research shows you have to get the comorbid conditions under control to get the migraine under control."

"The physician should be aware of the association between migraine and comorbid depression and other comorbid illnesses," agreed Dr. Arthur Elkind, head of the Elkind Headache Center in Mount Vernon, NY. "The physician has to carefully question the patient who has migraine and seems depressed...A patient with irritable bowel syndrome who goes to a doctor with a headache may not mention [the headache]."