Medical Updates
By Lisa Glickstein, Ph. D., Triplet Mom
Originally printed in October, 2004


Migraine:

Frova (a registered trademark) is a migraine treatment medication approved 
in 2002.  In a recent study published in the journal Neurology, this drug 
was administered twice a day starting two days premenstrually and continued 
for a total of six days.  More than half of the 546 women treated in this 
way had no menstrually associated migraine headache (compared with 2/3 of 
women in the placebo treatment who had headache).  Also, the regimen reduced 
the severity and duration of the headaches that did occur.  Frova is not 
approved for women with certain cardiac conditions (high blood pressure, 
congestive heart failure, for example) and should only be taken under a 
doctor's care.

Also, I found a note that women with migraine headache may be more likely 
to experience hyperemesis gravidarum.  It is already known that there is 
a link between migraine and cyclic vomiting syndrome, as well as motion 
sickness.


Polycystic Ovary Syndrome:

Two recent studies describe new findings relevant for women with PCOS.  
First, metformin (Glucophage, registered trademark) treatment was found 
to be equally effective as ovarian drilling in improving the ovulation 
rate (80%) and pregnancy rate (50-60%).  However, the advantages of 
Glucophage continued beyond conception, and women who received this treatment 
during pregnancy had a decreased miscarriage rate and possibly the incidence 
of gestational diabetes.  The second study found that women with PCOS who 
were also insulin-resistant (a precursor to type II diabetes) also had a higher 
incidence of obesity, darkened skin called acanthosis nigricans, facial hair 
growth, and resistance to Clomid.  The insulin resistance itself correlated 
with changes in the insulin receptor on cells, a possible mechanism.  Women 
in this category are at a greatly increased risk of developing type II diabetes 
later in life, and should be monitored closely.  Discuss with your primary 
care doctor treatment with Glucophage, with a goal of reducing body weight, 
as a preventive measure.


Post-partum Depression:

Fourteen women at high risk for PPD (based on history) were treated with Zoloft 
for 17 weeks immediately post-partum.  Only one suffered a recurrence of PPD, 
compared with four women (50%) in the placebo group.  The recurrence was 
significantly later in the Zoloft treatment group.


OTC Medicine:

Researchers have found that dextromethorphan (abbreviated "DM" on cough syrups) 
and diphenhydramine (an anti-histamine in some cough syrups) do not control 
night time coughing any better than sugar syrup alone.  The major finding of 
this study, published recently in the journal Pediatrics, is that symptoms 
improve gradually on their own, usually in one to two nights.  Support therapies, 
like drinking enough fluids, using a humidifier to alleviate dry winter air, and 
saline nose drops, may be the best course of action, according to doctors.


Asthma:

Thunderstorms create wind conditions that rapidly increase the concentrations of 
pollen antigens in the air, and can trigger epidemics of asthma.

Beta-agonists (Albuterol, Ventolin, Proventil) given to children using a metered-
dose inhaler with a valved holding chamber (also called a "spacer") were more 
effective than those administered using a nebulizer.  Children treated with the 
inhaler/spacer had fewer hospital admissions, and less severity by clinical score.  
The decrease in admissions was even more significant among children with moderate 
to severe asthma.  Using a spacer is also far less time-consuming and restrictive 
for children - the medication is dispensed into the spacer, and then the child 
inhales for 5-7 breaths in a soft mask.  Ask your pediatrician for more information.

Finally, for kids with pollen allergy and associated asthma, a recent study in the 
journal Allergy showed that children (age 6 to 17-years) who were treated with allergy 
shots preseasonally, and then the drug Xolair (which blocks IgE) during the allergy 
season, had fewer asthma exacerbations and less need for rescue medication than those 
treated with allergy shots alone, or Xolair alone.  Allergy shots, while decreasing 
allergy symptoms, did not reduce asthma attacks at all; Xolair alone was able to 
reduce asthma attacks to a lesser extent.  Speak to your pediatrician for more 
information.