Neurologists specialize in headache treatments and will diagnose migraine based on medical history, symptoms and physical and neurological examination. You may undergo an MRI scan to detect potential issues like brain tumours or strokes that could contribute to migraine.
There are various treatments for migraines available to treat them, such as painkillers and antimigraine medications that prevent future attacks.
Painkillers
Migraine painkillers are one of the primary treatments used to manage migraine headaches. Available over-the-counter and without any prior prescription needed, these medicines should be tested carefully prior to being taken as they could potentially make you diarrhoeal or even cause nausea and diarrhoea.
Ibuprofen (Advil, Motrin) is one of the best-known painkillers for migraine, with strong evidence supporting its effectiveness. Additionally, diclofenac sodium, naproxen sodium and acetylsalicylic acid all demonstrate similar levels of efficacy.
Triptans, such as sumatriptan (Imitrex and Tosymra) and rizatriptan (Maxalt), can quickly relieve migraine headaches when taken early during an attack – often within one to two hours after symptoms first emerge – known as abortive treatments. They come in pill form, nasal spray formulation or prefilled syringe forms for ease of administration.
Another solution may be using anti-sickness medicine such as ondansetron (Zofran) or prochlorperazine (Compazine), which are more effective than simple painkillers if nausea and vomiting are contributing to your migraine symptoms.
Anti-sickness medicines
Anti-sickness medicines may provide relief for migraine-induced nausea and vomiting. Anti-sickness remedies should be taken as soon as the headache symptoms appear, and are most effective when combined with painkillers and triptans for maximum effectiveness. Examples of such anti-sickness drugs are Ondansetron (Zofran) and prochlorperazine (Compazine).
Migraine prevention medications should be taken daily even when you do not experience an attack to reduce its frequency and severity as well as improve quality of life. Take these medicines according to instructions every time!
Aimovig (erenumab) and Emgality (galcanezumab), two new migraine-prevention medications, work by blocking the calcitonin gene-related peptide (CGRP) system involved with migraine nerve activity, with monthly injections. Your doctor can also prescribe beta blockers such as Propranolol (Inderal), calcium channel blockers like verapamil (Calan) as well as antiseizure medications like Valproate/Topiramate (Topamax) to help prevent migraines; however this medication should not be taken during pregnancy or while trying to get pregnant as it may affect fertility.
Triptans
Drs Jessica Ailani and Stewart Tepper present on the most up-to-date research and treatments for migraine in this webinar.
Migraines begin when certain neurons become overactive and blood vessels in the brain dilate, leading to pain and other symptoms. Triptans help calm overactive nerves while simultaneously shrinking blood vessels back down to normal; they may be taken either orally or nasally and work best when taken early during an attack.
Triptans include Imitrex (sumatriptan) and Rizatriptan (Maxalt); frovatriptan (Frova) and Naratriptan (Amerge), among many others, are long-acting medications that can be taken orally as tablets.
These medicines cannot be taken if you suffer from health conditions that affect the heart and blood vessels, such as high blood pressure or heart disease. Furthermore, they don’t work effectively when pregnant or breastfeeding – therefore you should speak to your healthcare provider regarding alternative treatments in these circumstances.
Other medicines
If over-the-counter painkillers and antisickness medications aren’t doing the trick, your doctor might suggest dihydroergotamine (DHE). This medicine comes as either an injection, infusion, buccal tablet, or spray, which dissolves between gum and cheek during migraine attacks and helps those who feel sick or vomit to recover faster. Domperidone or prochlorperazine might also be recommended to reduce sickness during attacks.
Drs Jessica Ailani and Stewart Tepper of Northwestern Medicine presented an online webinar discussing new acute therapies, preventive medications, and other solutions currently approved or being considered by FDA for migraine treatment.
Migraines can often be made worse by light and sound, so it’s best to seek shelter in a dark and quiet room during an attack. Sleep is also beneficial, particularly if you adhere to a regular schedule before sleeping; taking regular exercise and eating healthily may reduce both frequency and severity of attacks.
