Comorbidity of Migraine

The term comorbidity refers to the greater than coincidental association of two conditions in the same individual. Migraine is comorbid with many disorders (Table I). This can alert clinicians to identify them. Comorbid illness impacts pharmacologic treatment of migraine headache. One drug may be useful for more than one disease (i.e., valproate and topiramate may be therapeutic for both migraine and epilepsy). On the other hand, some treatments may be contraindicated in certain comorbid illnesses. Beta-blockers should be avoided in patients with migraine and depression. Careful attention to a drug's effect on comorbid conditions optimizes health care use and may improve patient's quality of life.

Individuals who seek medical care are more likely to have two independent diseases than are individuals who do not seek medical care, a phenomenon referred to as Berkson's bias. This can result in associations that are not apparent in population-based studies.

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