Migraine headaches are often described as an intense pulsing or throbbing pain in one area of the head, usually lasting from 4 to 72 hours if left untreated. Other symptoms of this debilitating disorder may include nausea or vomiting and sensitivity to light and sound.
Migraine affects more than 10 percent of people worldwide and is three times more common in women than men. About one-third of migraine sufferers can predict the onset of a migraine because it is preceded by visual disturbances called an “aura,” which may appear as flashing lights, zigzag lines or a temporary loss of vision.
People with migraine tend to have recurring attacks that are triggered by a variety of factors, including stress, hormonal changes, weather changes, lack of food or sleep, and certain types of foods. Researchers now believe that migraine has a genetic cause but its underlying pathophysiology is not fully understood.
Treatment for migraine focuses either on prevention, involving medications and lifestyle changes, and/or on the relief of symptoms. Stress management strategies such as exercise, relaxation techniques and biofeedback may reduce the number and severity of migraine attacks. Hormone therapy may help some women whose migraines seemed to be linked to their menstrual cycle, and they are likely to have fewer attacks and milder symptoms after menopause. For relief of symptoms, sumatriptan, ergotamine drugs and ibuprofen or aspirin may be effective.
With the proper combination of medications for prevention and treatment of migraine attacks, most people can overcome much of the discomfort caused by the disorder.
Migraines can be debilitating and disrupt your everyday life. There are ways, however, to prevent the onset of migraines. If you are experiencing frequent migraines (twice a month or more) or if migraines are impeding your ability to function, consider these treatment options.
Preventative methods can take the form of over-the-counter as well as prescription medication. Currently, the Food and Drug Administration has officially approved five medications for the explicit prevention of migraines, but other “off-label” medicines, i.e., approved by the FDA for other conditions, have also shown to be effective in migraine repression.
Nonsteroidal Anti-inflammatory Drugs (NSAIDS), such as fenoprofen, ibuprofen, ketoprofen, naproxen and naproxen sodium, have been shown to be successful in preventing migraines. Triptans can forestall migraines because they increase levels of serotonin, which constricts blood vessels and lessens pain. For menstruation-related migraines, frovatriptan, naratriptan, and zolmitriptan seem to be particularly helpful.
Though more commonly used to combat high blood pressure, beta-blockers, specifically propranolol and timolol are approved by the FDA for the prevention of episodic migraines. Via their positive impact on neurotransmitters, antidepressants, for example, venlafaxine and amitriptyline, are also effective at keeping episodic migraines at bay.
Similar to antidepressants, antiepileptic drugs enhance levels of neurotransmitters, thereby mitigating head pain. Of this class of drugs, topiramate and divalproex sodium are specifically approved by the FDA for migraine prevention.
Botulinum toxin type A (also known as Botox®) is the only medication approved by the FDA for the prevention of chronic migraines, defined as migraines that occur 15 or more days each month. Botox®weakens muscles and blocks nerve signals at the site of injection and is only recommended for those for whom oral medications have proved unsuccessful.
When deciding what preventive treatments to try, take into account your own individual migraine history. The pattern, duration, and triggers associated with your migraines will determine what may ultimately work for you.
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