We have been receiving an increasing number of questions relating to the current coronavirus (COVID-19) outbreak and the implications for migraine patients, so we thought it would be helpful to put together this list of Frequently Asked Questions and the answers to help you at this time.
I take ibuprofen for my migraine, should I continue to take it?
There have been recent reports that the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, could worsen coronavirus disease. The Infectious Diseases Society of Ireland has stated this message is false and has requested that anyone who has circulated the message remove it and explain that it is false. At this time, there is no strong scientific evidence connecting the use of NSAIDs with worsening COVID-19 symptoms.
The HSE is advising anyone with Covid-19 to continue to take any medication you were already taking, unless you are told not to by a healthcare professional. This includes NSAIDs such as ibuprofen (Nurofen), naproxen (Vimovo), diclofenac (Difene), etc. Stopping NSAIDs abruptly could result in some patients having to go to their GP or emergency departments.
I am on a monoclonal antibody / CGRP drug for migraine (Erenumab or Fremanezumab). Can it affect my immune system? Am I more at risk of getting seriously ill if I catch COVID-19 when on this drug?
From the clinical trials and use in practice, these CGRP monoclonal antibody drug treatments do not appear to compromise people’s immune systems and are not linked to increased risk of infections or immunosuppression. There is no evidence that these treatments suppress or activate the immune system. Patients should continue to take them unless advised otherwise by their specialist.
Will I still be able to contact my neurology clinic and attend scheduled appointments?
Patient safety is being prioritised to limit the risk of COVID infections. For this reason, most face-to-face neurology out-patient clinics have been cancelled. However, phone consultations are being provided by most of the Neurology teams and if clinically necessary, a face to face appointment can be scheduled in a non-COVID area if your consultant deems this to be necessary.
If you have an upcoming appointment or are worried about your appointment being cancelled you should contact your clinic and ask them for an update. Most new patient appointments have been cancelled and will most likely be rescheduled.
Please bear in mind that phone lines and neurology services will be extremely busy at this time, and that it may take some time to get through.
Can I continue my Botox treatment for chronic migraine at the Migraine Clinic during the current crisis? I have my injections every three months..
This will depend on the hospital where you have your injections, and you should contact your clinic or nurse specialist.
I am on oral preventive treatment for my migraine, should I continue to take it?
Yes, unless there are significant side effects. Please do not stop oral prophylactic or preventive medication abruptly. You will most likely be receiving a follow up consultation by phone if a neurology appointment has been scheduled previously.
I take Triptans and am unsure whether I should continue to take them with coronavirus?
Yes, you can continue to take Triptans (Zomig, Imigran, Frovex, etc) and paracetamol up to 4-6 days per month as before, unless there are clinical contraindications. For information on Medication Overuse Headache and how to avoid it see https://bit.ly/2xAHjgQ
Will I still be able to get my medication?
You may be worried about whether there will be a shortage of medication. The Irish Pharmacy Union (IPU) has reassured members of the public that pharmacies across the country are remaining open and medicines will continue to be available to treat patients. In a statement, the IPU said that “there are no supply shortages; stockpiling is completely unnecessary and, in fact, could itself trigger drug shortages.”
Stress triggers my migraine and I am very anxious and worried at this time – do you have any advice for managing stress?
It is a very stressful time at the moment, and many people are worried about how the current situation will impact their migraine. In the face of isolation and uncertainty, minding our mental health will be one of the immediate challenges that we all face. While this is naturally a worrying time, there are many things we can do to mind our mental health and boost our immunity and well-being at this time. Being proactive about how you handle this crisis can help to keep both your mind and body stronger. Here are some tips we have put together to help you.
- Focus on those things that are within your control. Hand washing, staying at home, limiting unnecessary travel and contact with others are steps we can all take to decrease our personal risk and protect others.
- Focus on the facts. The constant stream of social media updates and news reports about coronavirus could cause you to feel worried. Sometimes it can be difficult to separate facts from rumours. Use trustworthy and reliable sources, such as the HSE, to get your news.
- Practice good self-care. It’s important to pay attention to your self-care needs, especially during times of stress. Eating a healthy, balanced diet, avoiding excessive alcohol and stimulants, getting plenty of sleep, practising relaxation techniques, such as breathing exercises and meditation, and taking daily exercise are key ways to stay physically and psychologically healthy during stressful times.
- Stick to a daily routine. Your daily routine may be affected by the coronavirus outbreak in different ways. For those of us who are working from home maintaining a routine can be challenging. Try to stick to a working routine as much as possible – this includes structuring your day with regular breaks (try working in 45-60 minute chunks of focused work followed by a short break), minimizing distractions, stopping for lunch, getting some fresh air, avoiding staying in the same position for prolonged periods of time and keeping hydrated.
- Stay connected. Now is the time to pick up the phone, make a video call and stay in touch with each other. Mutual support is key to getting through this time.
You might also like to read our recent post on Migraine and Isolation for more tips and helpful resources.
Can I contact the Migraine Association if I have other questions?
We want to reassure you that we are here to provide as much support as we can during this challenging time. The situation with COVID-19 is rapidly evolving but our commitment to you remains consistent. Our phone lines remain open to you – Monday- Friday 10 am -12 pm and 2 pm – 4 pm. However, please note, you may receive a quicker response if you email us at firstname.lastname@example.org or contact us via our Facebook page www.facebook.com/migraineireland.
We will continue to update this page as more questions arise. For more FAQs on Migraine in general please see https://bit.ly/2Jq8kGs