Migraine is a debilitating condition that can dramatically diminish quality of life. Recent developments in migraine symptom relief and prevention have provided more treatment options.
Antimigraine medications that have proven successful at reducing migraine attacks without intolerable side effects include antidepressants, tricyclic antidepressants, and anti-seizure drugs such as valproate and topiramate.
Acute Management
Medication to treat migraine headaches early can include OTC pain relievers such as NSAIDs and acetaminophen, antiemetics and triptans; early use is most effective; they may even reduce nausea and vomiting that often accompany migraine attacks.
Keep a headache diary to help identify triggers and keep a record of your attacks. Keeping one can be done using either mobile phone applications or paper diaries; some individuals find it helpful to consult a healthcare provider in developing an action plan to manage migraines more effectively.
Migraine preventive medication does not completely eradicate migraine episodes, but does significantly lessen headache days and the severity of the ictal phase of migraine attacks. Drugs like CGRP monoclonal antibodies and gepants are particularly useful and well tolerated while other older medicines like antidepressants, anticonvulsants and antihypertensives may still provide some benefit but with reduced efficacy and potentially greater side effects risks.
Preventive Treatment
Migraines can be debilitating conditions that limit work and social life. Preventive treatments can reduce migraine episodes and their severity so people can function more normally.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the best treatments available to alleviate migraine. Studies conducted using double blind, randomized controlled trials provide proof of efficacy for such treatments such as aspirin, ibuprofen, naproxen sodium, tolfenamic acid and diclofenac.
Triptans may be used as an abortive medication when nonsteroidal anti-inflammatory drugs (NSAIDS) fail. Other preventive and abortive migraine remedies, including aspirin or paracetamol combined with codeine, caffeine and an antiemetic. Furthermore, new preventive migraine therapies known as CGRP monoclonal antibodies have shown promising results in recent trials.
Keep a headache diary to help better understand the unique prodrome, aura and pain characteristics of your migraines and to identify triggers and find the most effective preventive therapy options. A smartphone app or printable headache diary make keeping track of headache symptoms easy!
Neuromodulation
An electric or magnetic stimulation device may also be employed, especially if medications fail. Utilizing headache tracking tools like migraine diaries may help identify your prodrome, aura and pain symptoms so that together with your physician you can create the appropriate plan to address them.
Preventive therapies for migraines typically focus on modulating neurotransmitter systems with widespread effects across the central nervous system (CNS), because atypical pain processing, cortical hyperexcitability and peripheral sensitization all play a part in an attack [19].
Anticonvulsant medications such as magnesium supplements, nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen sodium as well as serotonin agonists are key elements of treatment for migraine headaches. Triptans such as naratriptan, frovatriptan and sumatriptan treat the throbbing aspects by blocking CGRP-dependent vasodilation in both brain and blood vessels; additional research suggests monoclonal antibodies may be effective; these include erenumab, frovatriptan and galcanezumab.
Other Treatments
Neurologists specialize in diagnosing migraines based on symptoms and medical history. Your physician may order an MRI scan to check your brain and blood vessels.
Common treatments for migraines include nonsteroidal anti-inflammatory drugs (NSAIDs), such as paracetamol (Panadol) and ibuprofen (Advil, Motrin). Absorption of these pills during an attack slows, so using soluble forms might provide better relief.
Amitriptyline (Trileptal, Elavil) can also help prevent migraine. Valproate or topiramate (Topomax, Qudexy) could also reduce your risk.
Some people with chronic migraine use feverfew as an alternative medicine; however, studies haven’t confirmed its efficacy.
