Migraine research is making great advances, with new options emerging for relieving symptoms and preventing attacks. This webinar will give an update on these developments.
Medication treatments for migraine include preventives and abortive treatments. Medication taken during the headache stage may reduce pain and nausea while aiding with aura symptoms like blurred vision or blind spots.
Over-the-Counter Pain Relievers
Meds to treat an existing headache are available both over-the-counter and by prescription. Nonsteroidal anti-inflammatories (NSAIDs), including aspirin, naproxen sodium and ibuprofen–reversibly inhibit cyclooxygenase enzyme activity which decreases prostaglandin production while also decreasing inflammation for pain relief. It is best taken at the first sign of migraine attack; even better when combined with Tylenol for maximum effectiveness.
Triptan drugs may help ease headache pain when taken at the first sign of an attack, with lasmiditan (Reyvow) showing great promise in clinical studies for relieving it, though its long-term use may have sedating side effects and cause stomach upset.
Preventive migraine medications don’t eradicate migraine attacks entirely, but they do reduce both frequency and severity by 30-50%. Most preventive medication must be taken daily in pill form – blood pressure medications like propranolol (Inderal, InnoPran) and beta blockers like verapamil (Calan, Verelan) have proven helpful for some individuals.
Identifying Triggers
People suffering from migraine often discover that identifying and avoiding triggers can help decrease both their frequency of headaches and medication dosage needs. Everyone’s triggers will differ; some examples include foods, hormones, changes to sleep or daily routine (such as skipping meals) as well as certain medicines; lights or glare, strong odors or stress could all act as possible migraine triggers.
Keep a headache diary to identify your triggers. There are apps available that enable you to record when and where your migraines start and end as well as any food and beverages that might trigger headaches such as cheese, chocolate or caffeine that could possibly trigger migraines in different people; cheese is often mentioned but many others may also cause headaches depending on who is experiencing them. It’s important to eat consistently without skipping meals to achieve maximum effectiveness in managing headaches.
Avoiding Triggers
Many people can successfully reduce migraine headaches by eliminating triggers. This includes avoiding bright lights, loud noises, strong scents and staying hydrated – in addition to cutting back on caffeine and alcohol intake.
Your doctor may suggest keeping a migraine journal to identify possible patterns and recognize any similar attacks as well as identify triggers. Experienced migraine sufferers are usually better at identifying patterns between attacks, as well as some possible triggers.
Food can often be the source of migraine headaches, with cheese and chocolate among the prime triggers, along with MSG, histamines, aspartame, cured meats and some oils and perfumes being especially problematic. Many find that by improving their lifestyle – through eating healthily, exercising regularly and managing stress better – they reduce their chances of migraine attacks significantly.
Medications
Drs Ailani and Tepper shared valuable insight on recent acute therapies as well as preventive medication available to address migraine.
Migraine painkillers include nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin) and anti-sickness medicines such as domperidone or prochlorperazine. Triptans target pain pathways in the brain to stop an attack without producing side effects.
Beta-blockers like propranolol can reduce migraine attacks. While initial dosage may be low, higher dosage may be increased as needed if necessary. They’re often recommended if other treatments fail or if taking them would present too many health complications.
Flunarizine, a type of calcium channel blocker medication, may also help prevent migraines. Unfortunately, it isn’t widely available in the UK and must therefore be imported under special license by a headache specialist.
Lifestyle Changes
A healthy lifestyle that includes exercise, balanced nutrition and adequate rest can reduce migraine attacks and their severity. Non-pharmacological prophylactic treatments like biofeedback and relaxation therapy also offer significant relief.
Neurologists specialize in headaches and can identify migraines based on your symptoms and medical history. An MRI scan may also help detect tumors, strokes or any other brain or nervous system problems which cause migraines.
CGRP inhibitors, or calcium-channel-gated receptor phosphoprotein inhibitors, work to block the action of a protein that causes narrowed blood vessels and flow changes during migraine attacks. Examples include Erenumab-aooe (Aimovig), Fremanezumab-vfrm (Ajovy), and Galcanezumab-gnlm (Emgality), which typically cause only mild side effects that tend to fade over time; other preventive medicines include triptans, NSAIDs or antidepressants.
