Comorbidities: An Overview
Why certain health conditions appear more frequently alongside migraine disease is not completely understood. But the comorbidity between migraines and other conditions such as stroke and epilepsy may be based on one of four links:
Coincidental
Causative, where one disorder causes the other
Etiologically based, with a genetic or environmental link between the two disorders
Etiologically based, where a particular physical state results in both disorders
The best treatment for migraine and a comorbid condition is often to find a drug that has had proven success in the treatment of both conditions. Care must be taken to ensure that a drug that treats one condition, like migraine, is not contraindicated for another condition. For example, beta-blockers (which are commonly used to treat migraine) should not be used on patients with asthma even though they are comorbid conditions.
In addition, doctors must be careful that drugs being taken for comorbid conditions do not cause or trigger migraines and that there are no harmful drug interactions between a migraine medication and the other drugs that a patient may be taking. The goal, then, is finding a drug that will safely treat both the migraine and the comorbid disease. Since many innovations in migraine treatment come from off-label use of preexisting drugs, there are a number of drugs initially intended for other conditions that have proven successful in treating migraines. These drugs are a natural starting point if a patient is found to have a comorbidity with a relevant condition.
