Migraine is a condition that affects all genders, with most patients experiencing symptoms throughout their lives. Although there is currently no cure available, various treatment options exist that can help manage symptoms as they arise.
Preventive therapies aim to decrease the frequency, severity, and duration of migraine attacks before they happen using both medications and devices.
Over-the-Counter Pain Relievers
Migraine headaches can bring on pain, nausea, and other symptoms that disrupt everyday life. Medication may provide temporary relief during an attack and prevent future attacks by acting both acutely and preventively; acute treatments must be taken at the first sign of migraine in order to reduce pain, sensitivity, or other symptoms quickly and reduce further symptoms that arise during an attack. Preventive medications should be taken on a regular basis for prevention.
Preventive migraine treatments should be taken on an ongoing basis to lessen both their frequency and intensity. Your physician will work with you to create a treatment plan tailored specifically to your needs, coexisting conditions (such as high blood pressure, depression/anxiety disorders, asthma or pregnancy).
OTC pain relievers such as ibuprofen (Advil, Motrin IB) and aspirin can provide temporary relief of mild to moderate migraine pain, while combination medicines combining ibuprofen with caffeine and acetaminophen may also be effective; Excedrin Migraine may also prove useful. Furthermore, newer drugs called calcitonin gene-related peptide antagonists (gepants), such as Ubrelvy and Nurtec ODT were shown to significantly reduce migraine pain within two hours in clinical trials.
Trigger Avoidance
Migraine triggers are things that lead to attacks of migraine headaches, and avoiding them can decrease their frequency. Common migraine triggers include strong perfume or fumes, certain foods, changes in sleep patterns or stress.
Avoiding triggers may help to stave off migraine attacks, and UT Southwestern physicians advise patients to keep a diary or calendar to document what sets off their symptoms. Sometimes certain triggers might even recur at regular times each week – this may help physicians detect patterns.
Trigger factors differ for everyone and their impact is highly individualistic; food allergies and sensitivities might be triggers, while others might tolerate them without issues. Migraine patients also report fluctuating thresholds for their migraine sensitivity – making it hard to pinpoint all possible triggers; instead, an approach called “learn to cope” may offer relief in the form of reduced frequency instead.
Medications
Migraines are severe headaches that often accompany nausea and vomiting. Medication may help prevent migraines as well as treat them when they occur.
Preventive medication should be taken daily to lessen how frequently and severely migraines strike, such as blood pressure medications such as propranolol (Inderal, InnoPran), verapamil (Verelan, Calan) and clonidine (Catapres). Antidepressants like Elavil/Norpramin/Amitriptyline may also be effective; however amitriptyline’s sleepiness-causing side effects must also be considered as potential migraine triggers; anti seizure medication such as Valproate (Depakote/Topiramate)/Topamax can also prove effective as preventive remedies.
Triptans are medications designed to relieve migraine symptoms when they start, and lasmiditan (Reyvow) can act as an abortive or preventive agent. An MRI may be necessary in order to rule out other potential triggers for migraines such as brain tumors or hemorrhages. Antiemetics can help manage nausea and vomiting caused by migraine. Antiemetics include Metoclopramide (Maxolon) and prochlorperazine (Dextromethorphan Promethazine); additionally nizatidine (Apo-Nizatidine Zyrtec), which targets the CGRP receptor in order to reduce nausea and vomiting.
Alternative Therapies
Migraine treatments go beyond medication and include nontraditional therapies like acupuncture and yoga that have been shown to alleviate migraine pain, while biofeedback and cognitive behavioral therapy may also help decrease headaches.
As pressure points on ears, hands, and feet — known as trigger spots — can relieve migraine pain when pressed, many people naturally use trigger spots to ease stress, muscle tension and headaches. According to researchers, acupuncture works by “adding chi” where there’s deficit or “removing chi” where there is blockage; its procedure involves inserting thin needles that remain in place for 20-45 minutes.
Researchers believe combining diet, exercise and supplements may help prevent migraines. Before adding anything new to your routine, consult with your physician first. Also, sudden headaches accompanied by stiff neck, rash or confusion should be evaluated quickly as this could be a sign of brain tumor or aneurysm; for these instances neuromodulation devices such as forehead bands that deliver mild electrical pulses or devices you hold against your neck during an attack are FDA-cleared as remedies and may provide additional help if more basic measures don’t.
