differences between migraine with and without aura

If research suggests that migraine with aura differs biochemically from migraine without aura. Are we being treated differently for our migraines or are we all put in the same bag and go through a list of treatments till we find something that works?

Has anyone being told that different meds like triptans, SSRIs or serotonin antagonist inhibitors wont work for them because of the type of migraine they have?

I don't understand why as someone who suffers with mostly aura symptoms they tried drugs also in the antidepressant category, increasing either production of serotonin or kind of controling it and keeping it in the brain, when tests have been done that suggest that during aura stage we have rather a lot of serotonin and it only dips in headache phase. What is the point in using a treatment that would only prevent the headache phase in a patient that rarely gets headaches , but gets aura symptoms every day?

Sorry to ask such an over involved question but I've spent most of the weekend looking at medical journals online and got a bit out of my depth, if anyone has managed to get any further with this in the past I'd really appreciate any links to explanations of this.

Di

dizzyflower wrote:If research suggests that migraine with aura differs biochemically from migraine without aura. Are we being treated differently for our migraines or are we all put in the same bag and go through a list of treatments till we find something that works? ...
Di

I've never seen any paper suggesting a fundamental difference between the types. I'd guess, from reading, that in people with, say, visual aura, whatever mechanism causes migraine in most people (spreading cortical depression?) also impacts, say, the visual areas of the brain. It's just less common.

I have read that people who get aura with their migraines are at a somewhat greater risk for strokes.

from reading a few now translated from papers written in Netherlands and a few others places serotonin does different things at different stages of a migraine, going up during aura, then getting dumped into the blood stream and depleting during pain stage.

It seems that what they are on about is basically the chemical reactions that happen in the brain to make that happen, which is the stuff I don't understand, but the bit I do is that if you don't get aura according to their theories, serotonin levels go very low, but people that do get aura start with it going very high, and have a high capacity for the stuff compared with the control set.

I can't seem to get much further with this to find the rammifications for medication.

dizzyflower wrote:...serotonin does different things at different stages of a migraine, going up during aura, then getting dumped into the blood stream and depleting during pain stage.

That would explain the plunge into depression that comes with the pain. The worse the pain, the pronounced is the depression (I've found anyway).

Becky