Living with Your Migraines: Tips for Treatment and Prevention
What is a Migraine Headache?
How Do Migraines Impact Your Quality of Life?
Medical costs due to the diagnosis and treatment of migraines surpasses $2 billion annually, and the World Health Organization ranks migraine as 19th highest disease to cause disability worldwide.
How Can I Tell if I Have a Migraine?
- Throbbing pain
- Light and sound sensitivity
- Nausea and/or vomiting
- Pain on only one side of the head
- Vision changes or blurred vision
Is There a Cure for Migraines?
What is An Aura?
About 80 percent of migraine headaches are not preceded by an aura, but involve vague symptoms such as mental clouding, mood swings, and fatigue.
What Might Trigger a Migraine Headache?
It is important for each person to keep a journal and try to identify any specific event or food that repeatedly precipitates their migraine attack so they can work to eliminate this trigger from their daily routine.
How Is a Migraine Diagnosed?
Migraine Treatments: What are the Options?
Acute Migraine Treatments: OTCs
Acute Migraine Treatments: Triptans
Triptans are very effective, but should not be used in patients at risk for a heart attack or stroke. Prescription medications in this class include almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig).
Acute Migraine Treatments: Ergots
Preventive Migraine Treatments: Tricyclic Antidepressants
Other TCAs used in migraine prevention, but with less data than amitriptyline on effectiveness, include doxepin and nortriptyline. Side effects like drowsiness and dry mouth are common with TCAs; starting treatment with low doses and taking at bedtime may help. All of these options are available generically and cost-effective for most patients.
Preventive Migraine Treatments: Beta-Blockers
Preventive Migraine Treatments: Calcium Channel Blockers
Preventive Migraine Treatments: Anti-Seizure Medications
Preventive Migraine Treatments: Botox
In the doctors office, multiple Botox injections are made into the muscles of the forehead and neck, and treatment is repeated every 12 weeks if successful. However, there are maximum dose limits to be aware of when Botox is used for other indications, such as to smooth wrinkles or for overactive bladder.
Migraine Agents for Nausea and Vomiting
Medications for nausea and vomiting can usually be used at the same time as medications used to treat the migraine. Traditional agents for nausea and vomiting include metoclopromide (Reglan, Metozolv), prochlorperazine, or promethazine (Phenergan). Metozolv is an orally dissolvable tablet, and prochloperazine and promethazine are available as rectal suppositories, which may be preferred over oral agents if nausea or vomiting is present.
Other Headache Types: Vestibular Migraines
Triptans or antiinflammatory medications are used in acute attacks; calcium channel blockers, selective serotonin reuptake inhibitors, and anti-seizure medications may also used to treat frequent vestibular migraines. Famed pop singer Janet Jackson suffers from this uncommon type of migraine.
Other Headache Types: Menstrual Migraines
In general, menstrual migraines tend to be more severe, last longer and occur more frequently than migraines that occur at other times. Menstrual migraines respond well to NSAIDs and/or triptans.
A Word of Caution: Migraines in Pregnancy
A Word of Caution: Rebound Headaches
A Word of Caution: Butalbital Use in Migraine
Finished: Living with Your Migraines: Tips for Treatment and Prevention
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- National Institute for Health and Clinical Excellence. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. June 2012. http://guidance.nice.org.uk/TA260
- Lipton RB et al. Migraine Diagnosis and Treatment: Results From the American Migraine Study II Headache: Journal of Head and Face Pain 2001:41;638-645
- Andersson KE, et al. Beta-adrenoceptor blockers and calcium antagonists in the prophylaxis and treatment of migraine. Drugs. 1990;39:355-373.
- Briggs GG, Freeman RK, Yaffe SJ, eds. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2008.
- Lite. J. What are vestibular migraines? Scientific American (online). October 16, 2008. Accessed July 12, 2013. http://www.scientificamerican.com/article.cfm?id=what-are-vestibular-migraines
- Migraine.com. Migraine Statistics. Accessed July 12, 2013. http://migraine.com/migraine-statistics/