Integrative approach to the management of depression-migraine complex - a case study

On 9/11/2010, a 55 year old Caucasian woman, presented at the clinic, with a decade old history of daily migraines. Early onset of migraines at age 11, were initially cyclical and related to menstrual cycle. Headaches increased in frequency and severity after marriage and bearing children.

Patient also started experiencing anxiety and depression in 1975. She was put on multiple agents for her complaints. In 2002, she had a seizure while on Wellbutrin, after which her headaches, anxiety and depression subsided for 5 years. Multiple imaging studies and neurological consultations at academic centers in Boston yielded no anatomical abnormality. Patient was on Gaba-pentin, Topiramate, Klonopin, Prozac and Propanolol at the time of presentation to Zanjabee.

An integrative protocol combining acupuncture and massage was developed for the patient, along with an advice for a largely unprocessed diet. Patient had complete amelioration of all her symptoms except insomnia over a period of 6 months. Her psychiatrist was able to wean her off of all her meds except Prozac, over this period. A sleep study showed that the patient had very little REM sleep and in consultation with psychiatry, Prozac was weaned off, resulting in relief from insomnia. Amongst other things, this case highlights the interference of SSRIs with sleep architecture, something that is not always considered while treating insomnia in patients with anxiety and/or depression. Patient continues to do well with a maintenance protocol of acupuncture and massage.