Headache

Updated 24 August 2016

Migraine-sufferers at increased risk of suicide or OD

A study found that both episodic and chronic migraines are associated with co-morbid psychiatric conditions like suicide and medication overdose.

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Suffering from frequent migraines can have a negative impact on many aspects of your day-to-day functioning.

Co-morbid psychiatric conditions

Migraine-sufferers often report a loss of concentration or a diminished ability to execute tasks such as driving. Whilst these are detrimental to your health, a new study indicates a more profound effect: Migraine-sufferers are at an increased risk of suicide or overdose from medication.

The study, which was published in the Headache Journal, examined case histories with expert opinions on the link between migraines and an increased risk of suicide. Both episodic and chronic migraines have been associated with co-morbid psychiatric conditions.

The study looked at previous studies that revealed chronic migraine-sufferers were 205% more likely to have depression and 140% more likely to have anxiety than episodic migraine sufferers.  Furthermore, the presence of these psychiatric co-morbidities in themselves “could lead to a higher rate of suicides in migraine-sufferers”.

Read: The best medication for migraines

The research also focused on medication overdose, especially with reference to opioids. It found that
11, 7–30% of all migraine patients use opioids. The researchers further found that data from pain clinics estimate opioid dependence to be as high as 19%. “In 2010 alone, opiates were responsible for 75% of the approximately 38,000 drug overdose deaths in the United States,” it stated.

Suicidal ideation

Dr Elliot Shevel, South Africa’s migraine surgery pioneer and the medical director of The Headache Clinic, says awareness of the increased risk of suicide in migraine-sufferers is a recently developing phenomenon and can stem from a lack of coping mechanisms, which would reduce the perceived burden of illness.

“In one study it was noted that migraine patients under the age of 30 had at least four times the odds of lifetime suicidal ideation than those over 65 years of age,” he says. “These patients should be treated within a multi-disciplinary team where the diagnosis is holistic, giving the patients a greater sense of sensitivity and understanding.”

Read: Migraines linked to a higher risk of 'silent' strokes

According to Shevel screening for opioid misuse is the cornerstone of protecting patients from drug related complications, including death. “Several effective screening tools exist like the Revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R) or the Opioid Risk Tool (ORT).”

He however warns there is a dearth of validated tests or tools to reliably predict patients who are not suitable for opioid therapy or those who need increased vigilance during therapy. “At the Headache Clinic we always opt for treatment that does not involve medications.”

'I have my sister back'

Sandra Bradford from England, visited Dr Shevel for treatment in South Africa recently, accompanied by her sister Jane Small. Jane convinced her sister to come to South Africa for treatment after she attempted to kill herself. “My sister suffered from chronic, almost constant migraine for nearly 9 years. In November 2015 she could no longer take the pain and tried to take her own life. She took an overdose of Topamax with Rum and jumped in a river.

After almost 10 weeks under treatment with Dr Shevel we returned to the UK and Sandy has been without migraine pain since mid-March. Her nine-year-old daughter Penny is thrilled to have her mum back and no longer in terrible pain. I have my sister back.”

Click here to read Sandra's full story.

Read more:

What is a migraine?

Causes of migraines

Treating migraines

 

Ask the Expert

Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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