An effective migraine treatment can improve your quality of life in multiple ways. Work will no longer be interrupted and activities planned without fear that pain will interfere.
Some medications used to prevent migraines had originally been intended for other purposes, including blood pressure medications, antidepressants and anti-seizure drugs. Other prescription that reduce migraine pain include Sphenopalatine Ganglion Stimulation and feverfew extract.
Avoiding triggers
Migraine triggers are anything that may initiate or worsen an attack of migraine, including foods like aged cheeses, alcohol, artificial sweeteners, caffeine, monosodium glutamate (MSG), and certain spices, as well as stressors such as skipping meals or fasting, changing sleep patterns, bright lights or glare, smells, hormonal shifts (especially during menstruation), climate fluctuations or weather fluctuations – as well as medications.
Most migraine sufferers can identify their triggers by keeping a diary of symptoms and times they appear, with some smartphone apps even available to assist.
Prodromal symptoms, or early warning signals of an imminent migraine attack, should also be carefully watched out for. They typically manifest in subtle yet easily recognisable ways such as changes in mood or emotion, craving specific foods, constipation, stiff neck or an increased sensitivity to sound, light or smell – any of these should be seen as potential warnings that an attack might be forthcoming. Avoiding prodromal symptoms is one of the best ways to avoid attacks altogether.
Medications
Many migraine sufferers find simple analgesics such as NSAIDs (such as ibuprofen) adequate to control pain during an attack, while more powerful triptans, which work by blocking pain pathways in the brain, can provide significant relief during an attack. Triptans come in pill form, nasal spray or injection form with sumatriptan (Imitrex, Tosymra) being the most effective drug available; others include Dihydroergotamine (Migranal Trudhesa) can reduce nausea and vomiting during an attack when taken either subcutaneously (subcutaneous injection), by mouth or through nasal spray; however this medication should not be administered due to coronary artery disease or high blood pressure issues.
Some headache medicines can help prevent migraines, though only certain have been shown effective in placebo-controlled trials. Antidepressants like amitriptyline may help, though not all patients tolerate these drugs. Anti-seizure drugs like valproate and topiramate might reduce migraine frequency or severity as well. Acupuncture may relieve headache pain for some individuals while relaxation techniques like biofeedback and cognitive behavioral therapy might also provide benefits.
Alternatives
If over-the-counter or prescription medications fail to alleviate your symptoms or cause side effects, consult with your physician regarding alternative remedies. He or she can evaluate if these are safe options that won’t interfere with other treatments you are receiving.
Botulinum toxin A (BTA) helps alleviate migraine headaches by blocking nerve endings’ release of acetylcholine from muscle fibres and thus reducing muscle spasm and pain while decreasing symptoms such as nausea, vomiting, photophobia and phonophobia.
Riboflavin can be found in many foods, such as lean meat, eggs, nuts, green leafy vegetables and dairy products. One study reported that people taking 400mg a day of riboflavin for three months experienced significant reduction in the frequency and severity of headaches.
Studies have demonstrated that acupuncture can assist in treating migraines by decreasing both frequency and severity of attacks, and possibly also decreasing medication usage.
Lifestyle changes
Migraine preventive therapy aims to decrease the frequency and episodes of migraine attacks and episodes, days with symptoms, severity of migraine symptoms, and days spent suffering with them. Lifestyle modifications including exercise, regular eating habits, cutting back caffeine consumption and using stress management techniques may greatly enhance treatment effectiveness.
People suffering from migraines can use supplements such as ginger, acupressure and certain essential oils to ease their symptoms. Yoga, meditation and prayer may also be effective at relieving stress. Furthermore, making sure they get sufficient sleep each night and avoiding foods like aged cheese, chocolate and alcohol which trigger migraines should also help.
Primary care physicians can help their patients modify triggers and increase adherence to medications through lifestyle counseling based around SEEDS: sleep, exercise, eat diary stress (79). A simple calendar-diary system can be helpful to monitor symptoms; there are also mobile phone apps dedicated to migraine diaries with more comprehensive data collection and adherence monitoring (80). Furthermore, sitting correctly while in prolonged sitting sessions may reduce neck and upper back muscles that have been identified as contributing to headaches.
