Several years ago aspirin was almost the only available treatment for migrain headache. Now there are drugs specifically designed to treat migraines.
There are two kind of migraine medications:
Pain-relieving medications. These stop pain once it has started.
Preventive medications. These reduce or prevent a migraine headache.
Choosing a preventive strategy or a pain relieving strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause and other medical conditions you may have.
You need a preventive therapy if you
- have two or more migraine headache attacks in a month
- use pain relieving medications more than twice a week
- pain-relieving medications aren't helping
- have uncommon migraines.
Some medications aren't recommended if you're pregnant or breast-feeding. Some aren't used for children. Your doctor can help find the right medication for you.
Pain-relieving medications
For best results, take pain-relieving drugs as soon as you experience signs or symptoms of a migraine headache. It may help if you rest or sleep in a dark room after taking them:
Over-the-counter medications for mild migraine:
- ibuprofen (Advil, Motrin, others)
- aspirin
- the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine)
If over-the-counter medications taken too often or for long periods of time, its can lead to ulcers, gastrointestinal bleeding and rebound headaches.
Drugs for stronger migraine:
- Triptan. It mimics the action of serotonin by binding to serotonin receptors and causing blood vessels to constrict. Triptan is available in oral, nasal and injection form. Injected triptan works faster than any other migraine-specific medication — in as little as 15 minutes — and is effective in most cases. But injections may be inconvenient and painful.
Example: Sumatriptan (Imitrex), rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig), almotriptan (Axert), frovatriptan (Frova) and eletriptan (Relpax).
Side effects of triptans include nausea, dizziness, and muscle weakness and, rarely, stroke and heart attack.
- Ergot.
Example: ergotamine (Ergomar), dihydroergotamine (D.H.E. 45), dihydroergotamine nasal spray (Migranal)These drugs may have more side effects than do triptans.
Preventive medications
- Beta blocker — which are commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines. Example: Calcium channel blockers,verapamil (Calan, Isoptin), antihypertensive medications lisinopril (Prinivil, Zestril) and candesartan (Atacand)
- Antidepressant. Example: tricyclic antidepressants; amitriptyline, nortriptyline (Pamelor) and protriptyline (Vivactil).
- Anti-seizure drug. Example: divalproex sodium (Depakote), valproic acid (Depakene) and topiramate (Topamax).
- Cyproheptadine. This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
- Botulinum toxin type A (Botox). Some people receiving Botox injections for their facial wrinkles have noted improvement of their headaches. However, it's unclear what effect Botox actually has on headaches. It may cause changes in your nervous system that modify your tendency to develop migraines. Additional research is necessary.
Saturday, May 19, 2007
Wednesday, May 16, 2007
Migraine headache types
Migraines headache are classified according to the symptoms they produce. The two most common types are migraine with aura and migraine without aura. Less common types include the following:
Abdominal migraine. Symptoms include abdominal pain without a gastrointestinal cause (may last up to 72 hours), nausea, vomiting, and flushing or paleness (pallor).Abdominal migraine is most common in children with a family history of migraine. Children who have abdominal migraine often develop typical migraine as they age.
Basilar artery migraine . Symptoms include severe headache, vertigo, double vision, slurred speech, and poor muscle coordination. This type occurs primarily in young people.
Carotidynia Its also called lower-half headache or facial migraine, produces deep, dull, aching, and sometimes piercing pain in the jaw or neck. There is usually tenderness and swelling over the carotid artery in the neck. Episodes can occur several times weekly and last a few minutes to hours. This type occurs more commonly in older people.
Headache-free migraine Its characterized by the presence of aura without headache. This occurs in patients with a history of migraine with aura.
Ophthalmoplegic migraine Its begins with a headache felt in the eye and is accompanied by vomiting. As the headache progresses, the eyelid droops (ptosis) and nerves responsible for eye movement become paralyzed. Ptosis may persist for days or weeks
Status migraine Its involving intense pain that usually lasts longer than 72 hours. The patient may require hospitalization
Some women experience migraine headaches just prior to or during menstruation. These headaches, which are called menstrual migraines, may be related to hormonal changes and often do not occur during pregnancy. Other women develop migraines for the first time during pregnancy or after menopause.
Abdominal migraine. Symptoms include abdominal pain without a gastrointestinal cause (may last up to 72 hours), nausea, vomiting, and flushing or paleness (pallor).Abdominal migraine is most common in children with a family history of migraine. Children who have abdominal migraine often develop typical migraine as they age.
Basilar artery migraine . Symptoms include severe headache, vertigo, double vision, slurred speech, and poor muscle coordination. This type occurs primarily in young people.
Carotidynia Its also called lower-half headache or facial migraine, produces deep, dull, aching, and sometimes piercing pain in the jaw or neck. There is usually tenderness and swelling over the carotid artery in the neck. Episodes can occur several times weekly and last a few minutes to hours. This type occurs more commonly in older people.
Headache-free migraine Its characterized by the presence of aura without headache. This occurs in patients with a history of migraine with aura.
Ophthalmoplegic migraine Its begins with a headache felt in the eye and is accompanied by vomiting. As the headache progresses, the eyelid droops (ptosis) and nerves responsible for eye movement become paralyzed. Ptosis may persist for days or weeks
Status migraine Its involving intense pain that usually lasts longer than 72 hours. The patient may require hospitalization
Some women experience migraine headaches just prior to or during menstruation. These headaches, which are called menstrual migraines, may be related to hormonal changes and often do not occur during pregnancy. Other women develop migraines for the first time during pregnancy or after menopause.
Migraine headache definition
Migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. It is often accompanied by extreme sensitivity to light and sound, nausea, and vomiting. Migraine is three times more common in women than in men. Some individuals can predict the onset of a migraine because it is preceded by an "aura," visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a lack of food or sleep, exposure to light, or hormonal irregularities (only in women). Anxiety, stress, or relaxation after stress can also be triggers. For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine is caused by inherited abnormalities in genes that control the activities of certain cell populations in the brain.
There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Many people with migraine use both approaches by taking medications originally developed for epilepsy and depression to prevent future attacks, and treating attacks when they happen with drugs called triptans that relieve pain and restore function. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. Stress management strategies, such as exercise, relaxation, biofeedback, and other therapies designed to help limit discomfort, may also reduce the occurrence and severity of migraine attacks.
There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Many people with migraine use both approaches by taking medications originally developed for epilepsy and depression to prevent future attacks, and treating attacks when they happen with drugs called triptans that relieve pain and restore function. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. Stress management strategies, such as exercise, relaxation, biofeedback, and other therapies designed to help limit discomfort, may also reduce the occurrence and severity of migraine attacks.
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