Migraines are debilitating conditions, impacting 39 million Americans. While migraines cannot be cured, treatments may alleviate symptoms and help prevent attacks.
Medication can either treat migraines as soon as they appear (acute treatments), or prevent their occurrence altogether (preventive medications). Preventive options include blood pressure medications (like beta-blockers), antidepressants and antiseizure drugs.
Medications
Migraine treatment usually encompasses both acute and preventive therapies. Acute therapies aim to reverse, or at least stop, an already established headache; preventive therapies are taken even when migraines don’t manifest in order to lessen their frequency and severity.
At-the-counter pain relievers like acetaminophen and aspirin may temporarily ease migraine discomfort, but medications targeted specifically towards headaches – including nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans – may provide greater relief. They work by blocking pain signals entering the body by targeting specific pain pathways in the brain and blocking off pain signals that would otherwise enter.
Additional oral migraine medications have now become available, such as monoclonal antibodies that act against the molecule known as CGRP that dilates blood vessels during an attack, such as rimegepant and ubrogepant. 5-HT1f medications may also provide some relief by decreasing inflammation and constriction of blood vessels during early attacks.
Antidepressants and antiepileptics may help decrease the effects of stress hormones on heart rate and blood pressure, while calcium channel blockers moderate constriction/dilation of blood vessels. Usually these medications should be started off at lower dosages before gradually increasing over 8-12 weeks for maximum effectiveness with minimal side effects.
Neuromodulation
Migraine is a condition that causes headaches to the head, neck, or face. The intensity can range from mild to severe and change over time. Other symptoms may include nausea and vomiting as well as light sensitivity, noise/odor sensitivity, slurred speech or even ringing in your ears.
Preventative medications for migraine include both abortive and preventive medicines, with the latter often serving to relieve inflammation and pain in the body. Common abortive medications include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen sodium, and acetylsalicylic acid being particularly effective. Antiemetics (metoclopramide, prochlorperazine or domperidone) may also help alleviate nausea/vomiting during an attack and should be combined with either antiemetics or triptans for maximum effectiveness.
Neuromodulation may be the ideal treatment solution for some individuals suffering from chronic migraine. Neuromodulation uses implantable devices that deliver low-voltage electrical stimulation directly into nerves for painless stimulation that alters how your brain processes pain signals.
Lifestyle changes
Healthy diet, regular exercise and adequate rest are crucial preventive steps against migraines. Moderate aerobic exercises have proven especially useful – even walking has been shown to decrease pain caused by migraines. Avoiding foods and drinks known to trigger migraines (e.g. caffeine) is also recommended, while keeping a headache diary and adhering to treatment principles may help pinpoint potential triggers.
Assist patients in creating a consistent bedtime routine and monitoring how many hours of restful sleep they get each night – 7-9 should be their goal!
Stress, anxiety and depression have all been linked with an increased risk of migraines. To decrease stress levels and frequency, patients can try practicing stress-reduction techniques like meditation, deep breathing or yoga; also encouraging regular physical activity (exercise) as well as maintaining a healthy weight by keeping an exercise regime consistent and drinking plenty of water – specifically 11.5 cups for women and 16.50 for men each day is ideal.
Counseling
Migraine headaches can be so debilitating they interfere with daily functioning, yet cannot be completely cured or managed. Although migraine symptoms cannot be eliminated completely, they can still be managed and prevented in an effective way. These include pounding or throbbing pain on one side of the head, neck, face, sinuses or jaw as well as light sensitivity, sound sensitivity and smell sensitivity as well as nausea, vomiting, abdominal cramping pains as well as yawning or thirst being reported by sufferers.
Some migraine sufferers experience aura, visual and sensory changes that serve as warning signals prior to experiencing headache pain (around 15%-20% of people who get them). An aura can last anywhere between 60 minutes and an hour and include flashing dots or sparkles that appear briefly before dissipating altogether.
Keep a migraine diary to help keep track of triggers and the results of medications you are taking, including symptoms, severity levels and what makes the migraine better or worse. Smartphone apps also exist that can do this task for you if pen and paper don’t suit.
