Epidemiology, impact, and comorbidities of migraine headaches in the United States

Migraine is a painful, disabling, and common disorder that imposes a substantial burden on individual headache sufferers and society at large. Although the prevalence of migraine has remained unchanged in recent years, the number of affected individuals continues to increase as the US population grows. The 1989 and 1999 American Migraine Studies provide insights into trends in epidemiology and patterns of medical care during the past decade and identify challenges in healthcare delivery for migraine. Of particular concern is a persistent treatment gap, reflected in the fact that the number of migraine sufferers currently consulting doctors for headache increased by 31% between 1989 and 1999, but that the proportion taking prescription drugs for migraine increased by only 4% between 1989 and 1999. Another consideration is that the individual and socioeconomic burdens of migraine are often compounded by psychiatric and neurologic comorbidities. Careful attention to comorbidities is required to establish accurate diagnoses, ensure the use of appropriate treatment strategies, and maximize quality of life. Concentrated educational efforts are warranted to increase the recognition of migraine as a legitimate medical condition and to encourage more widespread use of effective therapeutic modalities.