Treatments for Both Migraines & BP?
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Q:  Treatments for Both Migraines & BP?

Hi Dr. Phelps,

I've suffered from migraines for years and have also been diagnosed with BP (after a LOT of other things). You briefly touched on this in another email but didn't really go into detail.

I've done a lot of research, and there is amazingly little in the way of studies on the combination of these problems. First off I'm wondering why that is (lack of available candidates as opposed to people with one or the other maybe), but more importantly I'd just like to find something in the way of answers.

I've taken all kinds of meds - some for migraine; some for bipolar in order to try and solve one or the other. Inevitably trying to fix one always makes the other worse.

Are there any studies that have been done in this regard (the only one I am aware of is one done with melatonin)? I really don't want to take any more drugs until I see studies done on people with both problems.

Are there any drugs out there currently that are supposed to help people with both problems?


Dear Bobby -- 
There really are a lot of people out there with both bipolar disorder and migraines, so too few research subjects is not the problem.  Perhaps it's that migraine is a neurology problem, and bipolar is a psychiatry problem, and the two fields are rather oddly divided and distanced from one another -- that's my guess on the dearth of research.  

Puzzling though that you haven't found a treatment that might actually help both.  Depakote clearly can; verapamil theoretically can; and often when patients really get their cycling under control, their migraines are much better if not quite gone.  So from my psychiatry point of view (doctors so often think the thing they're treating is the most important of the disease processes the patient has) I'd focus on getting the bipolar side really well controlled and see what's left in terms of migraines.  Perhaps it means something that I've never seen a person's bipolar disorder come under control from a focus on the migraines, but again that could be my myopia. 

Dr. Phelps

Published December, 2004


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