Headache Infusion Therapy
Advances in medicine do not always come from discovery or development of a new drug; sometimes using an established drug for a new purpose makes a huge difference in treatment. Case in point: Headache infusion therapy.
Infusion therapy has been used for many years to alleviate the pain of chronic migraine and other intractable headaches, usually in an emergency situation. The treatment itself is pretty standard: Patients receive an intravenous infusion of a group of medications, including an anti-inflammatory, an anti-emetic (for nausea), and an allergy medication (like Benadryl, for example).
The latest research touted by the American Headache Society (AHS) and the American Migraine Foundation (AMF) shows that a new combination of medications used in headache infusion therapy would allow patients to receive relief in a headache specialist’s office rather than an emergency room or hospital setting.
“This new combination, or ‘cocktail,’ of medications to treat chronic, severe headaches is very beneficial to the patient, both in terms of time and cost,” explains Dr. Ben Taimoorazy of Guardian Headache and Pain Management Institute. “Headache infusion therapy administered in a hospital emergency room can take up to six hours. The therapy administered in the office takes only about an hour, at a fraction of the cost.”
The new cocktail includes a dose of Diprivan, a long-time anesthesia drug administered at a sub-anesthetic dosage. Not only does Diprivan help to abort and treat headaches, it has shown to provide freedom from subsequent headaches for up to a month or longer. This prolonged pain relief is truly a boon to chronic headache sufferers. “Ninety-seven percent of patients have relief with this treatment,” says Dr. Taimoorazy. For those who may have struggled with multiple debilitating headaches within days of each other, relief for up to a month is significant.
Patients who are prone to chronic, intractable or migraine headaches have an underlying sensitivity in their brain stem to a specific trigger or stimulus. “It varies from person to person, but common triggers include flickering light, strong smells, or certain foods such as cheese or wine,” explains Dr. Taimoorazy. This trigger begins a cascade of events in the brain stem: The brain hyper-reacts by sending out electrical signals via the trigeminal nerve, the largest nerve in the brain and a common pathway for many headaches.
The signals activated by the nerves cause a release of inflammatory material at the nerve endings causing irritation in the layers of blood vessels and tissue that cover the brain. The irritation causes more sensitization, causing the pain and throbbing of a severe headache. The throbbing is caused by the pulsation of the blood through these sensitized areas.
Headache infusion therapy attacks this cascade at various points to treat and reverse the inflammation and other symptoms. The anti-inflammatory medication works to decrease the inflammation and irritation of the nerve endings. The anti-emetic helps control the nausea experienced during a severe headache. The low dosage of Diprivan works on specific receptors in the brain, both related to pain. “Diprivan blocks NMDA receptors and stimulates GABA receptors, both actions serve as the body’s natural pain inhibitors,” says Dr. Taimoorazy. For safety reasons it is recommended that Diprivan be administered only by an anesthesiologist or nurse anesthetist because of their special training regarding how the drug should be used, dosage amounts, patient reactions, and other details.
Dr. Taimoorazy stresses the importance of proper headache diagnosis prior to this type of treatment. “This is not a treatment for a first-time headache sufferer,” he says. “It works well for established patients for whom the nature of their headache is known.” Headaches in general can be difficult to diagnose because it takes time and careful investigative work by a physician who knows what to look for.
In fact, overmedication of chronic headaches is often a problem. “There is such thing as a ‘medication overuse headache,’” he says. When a patient uses strong over-the-counter medications or prescribed medications, some of which are narcotics, to treat headaches more than 2-3 times a week, they can develop a secondary headache due to the medication itself.
“Medication overuse headaches are extremely difficult to treat, simply because the patient must be weaned off the medication to get back to the original headache. Then a proper diagnosis can be made.” Infusion therapy can be useful in getting rid of a medication overuse headache as well as treating the original headache.
The American Headache Society encourages those in the medical community to refer patients with intractable headaches to a headache subspecialist for proper treatment. The goal is to help patients sooner, especially before they develop medication overuse headaches. Not only can patients be helped by undergoing headache infusion therapy, but they can get relief more quickly, conveniently, and with significantly less cost.
For more information, you may contact Dr. Benjamin Taimoorazy at Guardian Headache and Pain Management Institute, 309-808-1700, www.GuardianPainInstitute.com . This new practice is located at 2203 Eastland Drive, Suite #7, in Bloomington Illinois.