Association Between PTSD & Episodic Migraine Stronger in Men

Women are more likely to experience migraine and post traumatic stress disorder (PTSD) separately. But new data says that although the rates of PTSD are higher among all people with episodic migraine, there is a stronger association between PTSD and episodic migraine for men. Given the greater disability experienced by patients living with PTSD and migraine, the treatment implications of this research are important.

A growing body of research has established a connection between PTSD and migraine disease. Researchers have looked at a variety of groups (headache clinics, veterans and the general population) and found similar results indicating an association between the two conditions. In fact, in one general population study migraine patients were at greater risk of experiencing PTSD than major depression or generalized anxiety. This, of course, begs the question of why.

Although they do not have the information to establish any kind of cause and effect relationship between PTSD and migraine, researchers believe PTSD may be associated with an increased predisposition to development of migraine. They also believe sex hormones may modify the PTSD / migraine association, which would explain why male migraineurs have greater odds of experiencing PTSD than female migraineurs.

Researchers do not yet know what happens in the brain that might be associated with both PTSD and migraine, but one possibility is lower serotonin and norepinephrin levels, which occur in both disorders. Additionally, migraineurs may have a greater biological likelihood of developing PTSD as a result of trauma because of their elevated rates of cortisol. Researchers believe higher levels of cortisol may predict future PTSD.

To date no studies have examined the impact of PTSD treatment on migraine severity, frequency, intensity or disability. But researchers believe existing data suggests that behavioral PTSD treatment alone may improve chronic pain and disability. They believe cognitive behavioral therapy alone or in combination with medication therapy should be considered for patients with PTSD and migraine.

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