Understanding & Treating Migraine in Older Adults
Key Questions
- What are the challenges of diagnosing migraine in older adults?
- How do primary and secondary headaches affect the differentiation of migraine in older adults?
- How can migraine symptoms and presentation differ in older adults?
- What migraine treatments are available for older adults?
- How can the benefits and risks of migraine treatments be evaluated in older adults?
- Which medical professional is best suited to manage migraine in older adults?
- Are there any specific medication interactions older adults should be aware of?
- Which migraine treatments should be avoided in people over 60?
- What affordable migraine treatment options are available for older adults on fixed incomes?
Interview Notes
- Yellow Rose Headache and Neuro-Ophthalmology, PLLC
- Study: “Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events”
- Study: “Risk of stroke and myocardial infarction among initiators of triptans”
- American Headache Society (AHS)
- National Headache Foundation
Treatments Mentioned
- CGRP small-molecule receptor antagonists (gepants)
- Ergotamine derivatives
- Neuromodulation devices
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- OnabotulinumtoxinA (Botox)
- Topiramate (Topamax)
- Transcranial magnetic stimulator (TMS)
- Tricyclic antidepressants (TCAs)
- Triptans
- Valproate (Depakote)
- Verapamil
Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.
Deborah Friedman, MD, MPH, FAAN, FAHS
Neuro-Ophthalmologist & Headache Specialist
Yellow Rose Headache & Neuro-Ophthalmology
Dr. Deborah Friedman is a neurologist specializing in headache medicine and neuro-ophthalmology. She practices at Yellow Rose Headache and Neuro-Ophthalmology in Dallas, Texas.
Dr. Friedman was the founding director of the Headache and Facial Pain Program and the Cerebrospinal Fluid Dynamics Program at the University of Texas Southwestern Medical Center. She is board certified in neurology and headache medicine. Additionally, she is a Fellow of the American Academy of Neurology, the American Headache Society (AHS), the American Neurological Association, and the North American Neuro-Ophthalmology Society (NANOS).
She served on the board of directors for the AHS and the Southern Headache Society, as a past president of NANOS, and on the steering committee for the Idiopathic Intracranial Hypertension Treatment Trial. She has published over 140 articles in peer-reviewed journals and 27 book chapters. Her key interests are intracranial pressure disorders, migraine, and cluster headache.
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