Online Program

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

Monday, November 4, 2013 : 4:30 p.m. - 4:50 p.m.

Pratibha Shah, Masters degree in Ayurveda, MPH, Integrative Medicine and Primary Care, Zanjabee, Woburn, MA
Basmaa Ali, Doctor of Medicine (MD), Medicine, Harvard Medical School, Woburn, MA
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.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe a successful integrative approach to a complex and chronic condition. Demonstrate effective collaboration between different modalities.

Keyword(s): Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Pratibha Shah holds a Post Graduate degree in Ayurveda from the prestigious National Institute of Ayurveda, Jaipur, India. She has been practicing Ayurveda for more than 20 yrs and conducts and speaks at Ayurvedic events all year round. With the aim of providing a wider platform for benefits from Ayurvedic principles of healing, she has recently completed Masters in Public Health, International Health, from Boston University School of Public Health.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Zanjabee Integrative Medicine and Primary Care Case study was recorded here Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.