Migraine Headache Treatment

Migraine headache treatment varies somewhat from treatment of most other types of headaches. While some medications and other treatments are similar, there are some drugs that are used for migraine that are not used for most other types of headaches.

Besides medication, migraine headache treatment can include various other remedies to help prevent migraine in patients who are prone to them.

Some examples of natural preventative treatments include:

  • Avoiding triggers: Many migraine sufferers come to recognize triggers that set off headaches. These are often food or scents that can be avoided and reduce the initiation of a migraine.
  • Excercise: Aerobic exercise decreases stress and tension and seems to reduce the frequency of headaches in many people. Getting regular aerobic exercise is an excellent, natural way to help decrease migraine headaches.
  • Avoid Estrogen: Women cannot completely avoid estrogen of course but many migraine sufferers notice an increase in headaches when high levels of estrogen are in their system. This explains why many women have cyclical patters of their headaches that follow their menstrual cycle. However, some women take medications that have high levels of estrogen, such as some birth control pills or hormone replacement therapy. Reducing or stopping these medications, if possible, can sometimes help to prevent migraines.
  • Other natural home remedies and prevention: Relaxation and relieving stress and tension can help both prevent migraines and ease the suffering of an ongoing migraine headache. Various natural, home remedies are often suggested to help relax including muscle relaxation exercises, getting enough sleep (but not oversleeping), and generally making time for rest and relaxation.

If these non-medication migraine headache treatments do not help, there are many medications which can be used as migraine headache treatment. Some people will benefit from over-the-counter pain medications such as ibuprofen or tylenol, especially in combination with caffeine, as in some drugs like Excedrin. However, these medications are often not sufficient for migraine headaches. The specific drugs that are used to treat migraines are generally either abortive or preventative.

Abortive Medications: Abortive drugs are medications which are not taken regularly. Rather, they are only taken once a migraine attack has started. It aims to prevent the progression of the headache, limit its severity and/or duration or abort it completely.

  • Triptans: The most commonly used abortive meds for migraine are a class of drugs called the triptans. All the generic names for the drugs have -triptan at the end. Examples include sumatriptan (Imitrex), zolmitriptan (Zomig), eletriptan (Relpax), and several others. In general, these drugs target serotonin receptors in the brain. The are quite effective for many migraine sufferers. Some are given orally but most are also available as fast acting nasal spray or injection.
  • Other Neurotransmitter Blockers: Whereas the triptans are relatively specific to serotonin, there are other drugs that have effects on serotonin as well as other neurotransmitters in the brain. While many of these are effective, they can have more side effects. They are occasionally used in patients for whom triptans have not worked. They include ergotamine (Cafergot), dihydroergotamine (Migranal), and acetaminophen-isometheptene-dichloralphenazone (Midrin).
  • Anti-Nausea Drugs: Anti-nausea drugs are sometimes prescribed to help treat nausea that often accompanies migraines. However, some patients report that they have an abortive or preventative effect as well. Examples include prochlorperazine (Compazine) and promethazine (Phenergan).
  • Opiate Pain Relievers: Opiates are strong pain blockers which are not specific to migraine but can be effective in controlling most types of pain. However, they do have side effects and can be quite addictive. Therefore they are not recommended for chronic therapy and are only used as a back-up if nothing else works well. Examples include butalbital (Floricet, Fiorinal) and acetaminophen with codeine (Tylenol with Codeine).

Preventative Medications: Preventative medications are drugs that are given regularly to help prevent the onset of migraine attacks in the first place. They do not work well to abort an attack that has already started. To have a good preventative effect, they must be taken regularly.

  • Blood Pressure Meds: Beta-blockers (propranolol or Inderal) and calcium channel blockers (verapamil) can help to prevent migraines in some patients.
  • Tricyclic Antidepressants: Some antidepressant meds are used as migraine headache treatment such as amitriptyline (Elavil) or nortriptyline (Pamelor).
  • Anti-seizure Medications: Gabapentin (Neurontin), valproic acid (Depakote) and topiramate (Topamax) are three seizure medications which are sometimes used to prevent migraines.
  • Antihistamines (Anti-Allergy Drugs): Some patients get relief from antihistamines such as diphenhydramine (Benadryl) or cyproheptadine (periactin).

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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