September 20, 2008

Treating your migraine headache




There was a time when aspirin was almost the only obtainable treatment for headaches. Today, many drugs, specifically designed to treat migraines are available in the market. Also, many drugs commonly used for treating other conditions help to relieve migraines in some people. All these medications and treatments fall into two classes -

1. Pain-relieving medications which help to stop pain once it has started.

2. Preventive medications which reduce or prevent a migraine headache.

Whether to choose a preventive strategy or a pain-relieving strategy would depend on the frequency and severity of the headaches, the degree of disability that the headaches cause and other medical conditions of the patient. One may be a candidate for preventive therapy if one experience two or more debilitating attacks a month, if one uses pain-relieving medications more than twice a week, if pain-relieving medications aren't helping or if one has uncommon migraines. In this article we would be mainly discussing pain-relieving medications and treatments.

Pain-relieving medications - for best results one should take pain-relieving drugs as soon as one experiences signs or symptoms of a migraine headache. It may help if one rests or sleeps in a dark room after taking them:

Nonsteroidal anti-inflammatory drugs (NSAIDs) - These medications include ibuprofen (Advil, Motrin, others) or aspirin and help to relieve mild migraines. Drugs marketed mainly for migraine, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), may also ease moderate migraines. If taken too often or for long periods of time, these may lead to ulcers, gastrointestinal bleeding and rebound headaches.

Triptans - Sumatriptan (Imitrex) was the first drug specifically made to treat migraines. It mimics the work of serotonin by binding to serotonin receptors and causing blood vessels to constrict.

Since the introduction of sumatriptan, many similar drugs have become available. These include rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig), almotriptan (Axert), frovatriptan (Frova) and eletriptan (Relpax) and usually provide pain relief within two hours for most people. Also these have fewer side effects and cause fewer recurring headaches. However the side effects of triptans include nausea, dizziness, and muscle weakness and, sometimes though rarely, stroke and heart attack.

Ergots - Drugs such as ergotamine (Ergomar) and dihydroergotamine (D.H.E. 45) and dihydroergotamine nasal spray (Migranal) also help to relieve pain.

Medications for nausea - Metoclopramide (Reglan) is helpful for relieving the nausea and vomiting associated with migraines, but not the migraine pain itself.

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