Migraine is a condition that causes severe headaches, often accompanied by other neurological symptoms like tingling, nausea and light sensitivity. Treatment options range from medications that treat acute attacks (acute treatment), as well as daily preventive ones.
Medicines may help alleviate symptoms and stop them from interfering with daily life. Your healthcare provider will discuss any family history of migraines as well as potential triggers that might exacerbate them.
Acute Medications
An acute medication is taken at the first sign of migraine to alleviate its symptoms. Over-the-counter pain relievers like aspirin or ibuprofen (Advil, Motrin IB) may help some with mild attacks; however, excessive use can lead to medication overuse headaches and even ulcers in the digestive tract. For severe attacks, triptans such as sumatriptan (Imitrex/Tosymra/Maxalt-MLT) or rizatriptan (Maxalt/Maxalt-MLT) are effective treatments; they work by blocking pain pathways in the brain and working by blocking pain pathways within.
Antiemetics that reduce nausea/vomiting are an excellent immediate treatment option, with Metoclopramide (Reglan), Prochlorperazine (Dorisil, Phenergan), and Domperidone (Motilium) among the most frequently taken antiemetics.
Antiseizure medications like topiramate (Topamax) may be taken daily to prevent migraines. Furthermore, many patients find relief with an antidepressant such as amitriptyline or venlafaxine in combination with an NSAID medication.
Preventive Medications
Migraine preventive medication should be taken daily in order to lessen the frequency and/or severity of migraine attacks, and reduce their frequency/severity. While preventive medicines are typically long-term solutions, they can also be taken short term before periods that might trigger migraine symptoms, such as exercise or menstruation; or to prepare patients who will be exposed to altitude/noise changes etc.
Some medications originally designed to treat other conditions – beta-blockers and tricyclic antidepressants among them – were later discovered to prevent migraine as well. Others like sodium valproate and topiramate, known as anticonvulsants and typically used to treat epilepsy, were also found effective against migraine in low doses.
CGRP monoclonal antibodies such as Erenumab-aooe (Aimovig), Fremanezumab-vfrm (Ajovy), Galcanezumab-gnlm (Emgality) and Eptinezumab-jjmr (Vyepti) are among several new medications approved to prevent migraines. They should be injected every month or three months via injection; reactions at the site of administration are the most frequently experienced side effect.
Behavioral & Lifestyle Changes
Behavior and lifestyle modifications may help mitigate migraines when used in conjunction with medication, such as keeping to a regular sleep schedule and avoiding foods known to trigger migraines. Exercise releases endorphins that reduce stress, which further contribute to migraine prevention; find an enjoyable physical activity suitable to your body as overexertion can worsen headaches in some people.
Keep a headache diary to track triggers, symptoms and treatments as well as any patterns. This allows healthcare teams to more effectively diagnose and treat your migraines. Furthermore, stress and anxiety are known to contribute to migraines; thus incorporating stress-relief techniques like mindfulness meditation, deep breathing exercises or biofeedback into daily life may make a big difference for this condition. Furthermore, regular physical exercise and weight management is vital.
Neuromodulation
Migraines are painful and debilitating headaches that require medical care to manage effectively, so as not to disrupt daily activities and responsibilities. A healthcare provider can assist in relieving pain so as not to interfere with daily tasks and activities.
Migraines typically last 4 to 72 h and are typically characterized by unilateral location, pulsating quality and moderate-to-severe intensity. Additional symptoms associated with migraine headaches may include unilateral location, sound sensitivity (phonophobia), visual aura and nausea/vomiting4. Aura may occur alone or concurrent with migraine in up to 90% of affected individuals4.
Many medications used to treat migraines have already been FDA-approved to treat other medical conditions, like high blood pressure or depression. When prescribed to treat migraines at lower doses than their original purpose.
Assess treatment response as soon as initiation or change in therapy has taken effect, as well as on an ongoing basis. Referring patients who remain adversely impacted by migraine despite optimal acute therapy may require specialist consultation.
