Treatment and Prevention
Sometimes you can cut down the number of migraine attacks 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 - so you can reduce your risk of migraines!
There are some measures you can take to help reduce the number of attacks: avoid
sleep deprivation and undue stress and maintain a regular exercise program and
good nutrition. When these measures do not solve the problem, medication may
be required.
There are two basic types of migraine medication: abortive medications
are used to control the pain of an existing attack, and prophylactic medications
are taken to prevent migraine attacks.
Abortive medications include:
- painkillers such as aspirin, acetaminophen, or ibuprofen
- these may be enough for milder attacks
- non-steroidal anti-inflammatory medications such as naproxen - these may
be effective in more severe attacks, especially when they are related to menstrual
periods
- ergot preparations that constrict the dilated blood vessels - for
example, DHE is a fast-acting nasal spray
- triptans (e.g., sumatriptan, naratriptan, zolmitriptan, rizatriptan,
almotriptan) - the latest anti-migraine medications; they mimic serotonin
and also constrict blood vessels to relieve pain
Prophylactic medications include:
- anti-seizure drugs such as valproic acid, gabapentin, and topiramate -
these may stabilize nerve cells and prevent the brain hypersensitivity that
triggers the attacks
- beta-blockers and calcium channel blockers - these can prevent headaches
by stabilizing blood vessels to prevent the contraction/expansion cycle
- riboflavin (vitamin B2) or magnesium supplements - these may help some people
with migraines
- serotonin blockers such as methysergide or pizotifen - these may also be
effective
- tricyclic antidepressants - these reduce migraines by increasing the level
of serotonin and other brain chemicals
A headache specialist might recommend other therapies:
- There are herbal products like feverfew, which has been used to treat fever
and headaches for centuries. Research suggests it might help prevent migraines.
- Relaxation therapy and biofeedback aims 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.