Treatment and Prevention
Sometimes you can cut down the number of migraine headaches you have by avoiding potential triggers. Identifying migraine triggers isn't easy. Many doctors recommend keeping a headache diary. By recording the circumstances (e.g., emotions, foods eaten) surrounding your migraines, you may eventually figure out what situations to stay clear of to reduce your risk of migraines
There are some measures you can take to help reduce the number of migraine headaches: avoid sleep deprivation and undue stress, and maintain a regular exercise program and good nutrition. Other techniques such as yoga, meditation, and biofeedback techniques may also be helpful. When these measures do not solve the problem, medication may be required. Document the techniques you've tried and how well they worked in your headache diary, too.
There are two basic types of migraine medication: abortive medications are used to control the pain of an existing migraine headache, and prophylactic medications are taken to prevent migraine headaches. The choice of treatment depends on the severity of migraine, other medical problems, and on how often migraines occur.
Abortive medications include:
- pain medications that contain aspirin, acetaminophen*, ibuprofen, or naproxen for mild to moderate migraine headaches
- ergot preparations such as ergotamine or dihydroergotamine (DHE) that constrict dilated blood vessels
- triptans (e.g., sumatriptan, naratriptan, zolmitriptan, rizatriptan, almotriptan, frovatriptan, eletriptan) that mimic the chemical messenger serotonin, constricting blood vessels to relieve pain
- metoclopromide, chlorpromazine, prochlorperazine, and dimenhydrinate may also be used
Prophylactic medications include:
- tricyclic antidepressants such as amitriptyline and nortriptyline
- antiseizure medications such as valproic acid, gabapentin, and topiramate
- beta-blockers and calcium channel blockers
- riboflavin (vitamin B2) or magnesium supplements
A headache specialist might recommend other therapies:
- There are herbal products like feverfew that might help prevent migraines.
- Relaxation therapy and biofeedback aim to teach people to control body functions such as temperature and pulse.
- Behavioral therapy involves learning how to avoid headache triggers by changing behavior.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist
Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network.