"Most studies support that migraine is associated not only with bipolar disorder but also with major depression, panic disorder, social phobia [8, 9], drug abuse [10], suicide, and neurological and internal diseases too, for instance stroke or hypertension [11]. " 1.
"Vice versa, according to a review of literature of McIntyre et al. [12], subjects with other neurological diseases, such as epilepsy or multiple sclerosis, seem to have a higher occurrence of bipolar disorder." 2.
"There is no proven treatment regimen for migraine with comorbid bipolar disorder, so that pharmacological therapy is still a matter of trial and error. Nevertheless, some remedies seem to have effects on both of the diseases, but one must be wary of purchasing the benefit of a remedy in one disease by worsening the other." 3.
"Migraine is an important comorbid disease in bipolar patients. It not only strengthens the cause of bipolar disorder but also worsens the recurrence rate with regard to depressive episodes. Bipolar II patients have a higher susceptibility of having comorbid migraine." 4.
"Approximately 4% of the population suffers from bipolar disorder, but bipolar illness is seen with increased frequency in the migraine population.3Studies have indicated that from 7.2% to 8.6% of migraine patients fit the definition for bipolar spectrum.3,4 Conversely, several studies have indicated an increased risk for migraine in patients with bipolar spectrum disorders.5,6 One study indicated that in bipolar patients, 14.9% of the men and 34.7% of the women had a lifetime occurrence of migraine.5 Additional studies of the bipolar population resulted in a lifetime migraine prevalence of 39.8% for men and 44% for women.6" 5.
"Recognizing bipolarity in headache patients has a significant impact. When bipolar disorder is not recognized, these patients often are given antidepressants alone, with predictably poor results. While of some benefit, these medications generally are not effective for the bipolar spectrum and may trigger mania or hypomania. The presence of bipolar illness complicates the treatment of RCM. Mood stabilizers that help both conditions, such as lamotrigine or sodium valproate, are important. Atypical antipsychotics—quetiapine (Seroquel, others), olanzapine (Zyprexa, others), aripiprazole (Abilify), etc.—sometimes help both headaches and moods. Psychotherapy plays a vital role with these patients." 6.
"The most interesting finding was a substantial difference between patients with BDI and BDII, with migraine being clearly more prevalent in the BDII than in the BDI group. In our second study, 82% of the patients with BDII had migraine, compared to 27% of the patients with BDI (Figure). There is much evidence, including our own, indicating that patients with BDI and BDII represent two different nosological conditions (Coryell, 1996). Our results are similar to those of Endicott (1989), who found, among patients with major affective disorders, the highest frequency of migraine (51%) in patients having characteristics similar to patients with BDII as defined in the present study." 7.
"In two epidemiological studies, one from Zurich, Switzerland, (Merikangas et al., 1990) and one from Detroit (Breslau and Davis, 1992), a clear relationship between migraine and major affective disorders has been found (Breslau et al., 1994). In the Zurich study, people with migraine had a threefold-increased one-year prevalence of bipolar spectrum disorders (9% versus 3%), a nonsignificant increase in manic episodes and a twofold-increased prevalence of major depression (15% versus 7%)." 8.
"Several studies, both open and controlled, have shown that valproate (Depakene) has prophylactic effect in migraine, reducing the number of attacks, duration of headache and intensity of pain (Silberstein, 1996). Valproate thus has effect on the three main symptom groups in patients with migraine and comorbid affective disorders: headaches, mood instability and panic attacks (Freeman et al., 2002)." 9.
1, 2., 3., 4., https://www.hindawi.com/journals/crim/2012/389851/
5., 6. https://www.practicalpainmanagement.com/pain/headache/migraine/difficult-treat-chronic-migraine-bipolar-spectrum-personality-disorders
7., 8., 9. https://www.psychiatrictimes.com/bipolar-disorder/are-migraines-and-bipolar-disorder-related
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