Jim Linman, a pharmacist, will be the featured speaker at the February meeting of the East Bay Headache Support Group. As a specialist in compounded prescriptions, he will talk to us about custom formulating medicines for the relief of headaches. Mr. Linman graduated from the UCSF Pharmacy School in 1958 and has been in practice in Walnut Creek since 1964. He is past president of the Contra Costa Pharmacy Association and a member of the Professional Compounding Centers of America.

A scientific controversy is brewing over the pluses or minuses of magnesium, a reputed low-cost treatment for migraine headaches. Magnesium’s migraine-busting merits have been heralded by some researchers, while others have doubts.

Magnesium enthusiasts enjoyed the spotlight Saturday (June 27, 1998) at the American Association for the Study of Headache meeting in San Francisco.

They drew hope from a speech by new York City neurologist Dr. Alexander Mauskop, who reported a "strong possibility" that magnesium combats migraine attacks and has "minimal side effects." He spoke on the second day of the three-day conference at the Sheraton Palace Hotel on Market Street.

Migraine attacks can last for days and cause excruciating pain, usually on one side of the head. They also can bring vomiting and hypersensitivity to light, sound and smell.

In some patients, magnesium alone "can dramatically reduce their (attacks) frequency," and cut migraine pain by more than 50 percent within 15 minutes, Mauskop said. He is an associate professor of clinical neurology at the State University of New York Health Science Center in Brooklyn.

He and his colleagues—B. T. Altura, R.Q. Cracco and B. M. Altura—tested the mineral by injecting it intravenously into migraine sufferers.

However, "a lack of definitive proof" keeps Mauskop from whole-heartedly recommending magnesium as a migraine treatment for now.

Also, no migraine sufferer should take magnesium without first consulting a physician, Mauskop cautions. Excessive doses of magnesium can be dangerous, he warned.

What’s needed, Mauskop says, are more careful, "double-blind" studies of magnesium. The mineral can be bought without a prescription at health-food outlets and other stores.

In science, a double-blind study is one in which the researchers don’t know which patients received the real drug and which are "controls" given placebos with no medicinal effect. If properly conducted, a double-blind study ensures that researchers’ prejudices about a proposed treatment don’t influence their conclusions.

In 1996, the German researcher Volker Pfaffenrath and his colleagues questioned the value of magnesium for treating migraines. They published a report in the medical journal Cephalalgia that concluded, based on a double-blind study, the mineral offers no significant benefits for migraine victims.

However, Mauskop noted Saturday, Pfaffenrath’s patients tended to suffer diarrhea after receiving the magnesium. This suggests their bodies weren’t absorbing the mineral. Hence they might not have been benefiting from magnesium’s anti-migraine effects, Mauskop theorizes.

Exactly how magnesium might ease migraines remains uncertain. One possibility: It might widen blood vessels that tend to narrow during migraine attacks.

Magnesium is one of a number of "alternative" therapies for migraines, which afflict more than 20 million Americans—perhaps twice that many, according to one estimate. Three trimes as many women report migraines as men—although cynics might attribute the difference at least partly to men’s legendary unwillingness to admit that they’re in pain.

At the least, Mauskop suggests that doctors show more sensitivity to the feelings of patients who resort to "alternative"—i.e. unorthodox—therapies such as magnesium. Too often, he says, patients fail to tell a doctor that they’re pursuing alternative treatments—say, acupuncture—for fear that the physician will scold or scorn them. And a doctor can best serve his patient’s needs if fully appraised of what treatments the patient is seeking outside the medical office.

Of the many popular alternative therapies for migraines, exercise and biofeedback are the likeliest to help, Mauskop says. Biofeedback must have some value, he adds half-jokingly, "because insurance companies pay for it."

Excerpted from the June 28, 1998 issue of the San Francisco Examiner

About 7 million Americans suffer from daily or nearly daily headaches, defined as headaches that occur at least 180 days a year. A phone interview survey of over 13,000 people found that frequent headaches were nearly twice as common among women as men. The most common form of frequent headache in the study was chronic tension-type headache, accounting for 53% of the frequent headaches suffered. The study appeared in the July/August 1998 issue of Headache.

Nearly half of people with chronic tension headaches may also have anxierty or depression, according to a study by Dr. Gay Lipchik and colleagues. For the study, 245 people with chronic tension headaches completed questionnaires assessing their psychological condition. Forty-five percent of those surveyed said that they felt depressed, hopeless or anxious nearly every day. Some 2% to 3% of Americans have chronic tension head-aches. The study was presented at the 40th AASH Annual Meeting.

Excerpted from the Fall 1998 issue of Headache, the newsletter of the American Council for Headache Education.