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Bertrand Doeuk and Dr Nicole Limberg on Migraine Health News

In this episode of Migraine Health News Bertrand Doeuk from The Brisbane Headache and Migraine Clinic™ interviews Dr Nicole Limberg a neurologist from Migraine Specialist. The discussion is based on the new codeine medication laws, which will be in effect as of the 1st of February 2018 in Australia, which will affect the estimated 3 million migraine sufferers.

From this date all low dose codeine medication that used to be available over the counter at pharmacies, will now require a prescription from your doctor in order to purchase these medications. This means you will no longer be able to visit your pharmacist to purchase these medications over the counter, without first visiting your doctor to get a prescription.

What does this mean to you as a headache and migraine sufferer?

The first question we should ask is what does codeine medications do to you, and why do millions of headache and migraine sufferers take codeine medications?

Many codeine users would know these medications such as Panadeine, Panadeine extra, neurofen plus, mersyndol and even cold and flu tablets such as codoral. Headache and migraine sufferers take these analgesic (pain-killer) medications, sometimes without knowing the long-term consequences involved with these medications. Codeine is classified as a ‘weak’ opioid. Opioids such as morphine and heroine can have severe side effects. Much like codeine medications that headache and migraine suffers take, they too have the same adverse effects as morphine. These adverse side effects can include liver damage, addiction, medication overuse headaches and even deaths.

In addition Dr Limberg explains how trials fail to show that weak opioids have markedly superior analgesic efficacy to simple medications such as paracetamol or NSAIDs (Non Steroidal Anti-inflammatory Drugs). This suggests that headache and migraine sufferers should take medications such as paracetamol, ibuprofen, advil, or even Indocin rather than codeine medications. Dr Limberg also reveals that codeine and opioids are not recommended in the treatment of tension type headaches or migraines.

It is also important to note, as Dr Limberg suggests that codeine and opioids are known to be a psychotropic drug. This means a class of drugs which will affect a person’s mental state which may cause drug abuse, and addiction.

Bertrand Doeuk further explains how codeine dependency use can result in Medication Overuse Headaches (MOH). He explains how according to recent studies MOH is regarded as the 18th highest cause of disability world wide. When combining that with migraine disability, you now have headaches and migraines being the 3rd highest cause of disability in the world.  The only thing that tops this is low back pain and depression as the top two disabling conditions. Dr Limberg also explains how MOH is likely to be the most costly disorder world-wide.

The Therapeutic Goods Administration have decided to ban over the counter codeine medications as of the 1st of February 2018. Both Bertrand Doeuk and Dr Limberg agree that this is a wise move in order to prevent the health issues, mental issues and even deaths associated with Codeine medications.

Dr Limberg further explains how this will assist sufferers in talking to their doctor in order to get a strategic plan in place to assist with headaches and migraines. Medication strategies that may be of significant benefit include:

  • Introduce appropriate migraine prophylaxis
  • Use a staged approach to acute headache treatments
  • Use non steroidal anti-inflammatory drugs or simple analgesics for mild headaches
  • Use triptans for more severe headaches (but not exceeding 10 days per month; and
  • Avoid codeine containing medications

For further information feel free to contact Bertrand Doeuk from the Brisbane Headache and Migraine Clinic™ or Dr Nicole Limberg from Migraine Specialist.

Bertrand Doeuk

Brisbane Headache and Migraine Clinic


 1800 43 23 22



Dr Nicole Limberg

Migraine Specialist

Ph: (07) 3831 1611



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