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Treatment of Migraine and Related Headache
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Migraine Treatment

Most people who suffer from migraine can deal with mild-to-moderate migraine attacks at home. The following measures may help in relieving migraine headaches to a certain extent. You must:
  • Use a cold compress to the area of pain
  • Rest with pillows comfortably supporting the head and neck
  • Rest in a dark, quiet place
  • Avoid pungent odours
  • Withdraw from stressful surroundings
  • Sleep
  • Drink a moderate amount of caffeine

In addition, a variety of drugs have been specifically designed to migraine treatment. Medications used to combat migraines fall into two broad categories. They include:
  • Pain-relieving medications: Also known as acute or abortive treatment, these drugs when taken during migraine attacks, can stop the symptoms that have already begun.
  • Preventive medications: These drugs are almost always meant to be taken regularly, on a daily basis, to help reduce the severity or frequency of migraine headaches.

Pain-relieving medications: These drugs must be taken as soon as the signs or symptoms of a migraine are experienced. Sleeping or resting in a dark room may also help. These drugs are:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help relieve pain. NSAIDs must not be taken for a long period of time or else it may lead to ulcers, gastrointestinal bleeding and rebound headaches.
  • Triptans: For severe migraine attacks, Triptans are the drug of choice. They effectively relieve migraine associated pain and nausea as well as sensitivity to light and sound. Side effects of triptans include nausea, dizziness, muscle weakness and, rarely, stroke and heart attack.
  • Ergots: Ergotamine, a common prescription for migraine, was in use long before triptans were introduced.
  • Anti-nausea medications: Since migraine attacks are often accompanied by nausea with or without vomiting, medication for nausea is appropriate and is usually combined with other medications.
  • Butalbital combinations: These medication combinations are sometimes used to treat migraine attacks. These medications, however, have a high risk of rebound headache and withdrawal symptoms and must therefore be used infrequently.
  • Opiates: Medications containing narcotics, particularly codeine, are sometimes used to treat migraine pain in people who cannot take triptans or ergots. These drugs are habit-forming and must be used only as a last resort.

Preventive medications: These medications often help in reducing the frequency, severity and length of migraines as well as increase the effectiveness of symptom-relieving medicines. Preventive medications are generally recommended for daily use, or when a predictable trigger like menstruation is approaching. Some preventive medications include:
  • Cardiovascular drugs: Beta blockers commonly used to treat high blood pressure and coronary artery disease can reduce the frequency and severity of migraines. These drugs are generally considered as the first line of treatment. Calcium channel blockers another class of cardiovascular drugs, may also be helpful. In addition, antihypertensive medications are useful in preventing migraines
  • Antidepressants: Certain antidepressants can effectively prevent all types of headaches, including migraines. These medications reduce migraines by affecting the level of serotonin and other brain chemicals.
  • Anti-seizure drugs: Although the reason is unclear, some anti-seizure drugs, seem to prevent migraines. In high doses, however, these anti-seizure drugs can cause side effects, such as nausea and vomiting, diarrhea, cramps, hair loss and dizziness.
  • Cyproheptadine: This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
  • Botulinum toxin type A (Botox): People receiving Botox injections for facial wrinkles have noted improvement in their headaches. Although the mechanism itself is unclear, the drug may cause changes in the nervous system that modifies the body's tendency to develop migraines.

By Mark Bevan
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