Treatment of Migraine

Migraine is a neurological syndrome characterized by altered bodily perceptions, headaches, and nausea more common to women than men. Migraine is a very painful type of headache with throbbing or pulsating pain in one area of brain caused by a combination of enlargement of blood vessels and the release of chemicals from nerve fibers that surround the blood vessels and is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

 

There is no cure or medications for migraine headache but the drugs can help reduce the frequency and severity of migraines. There are many drugs specifically designed to treat migraine which are given below

Pain Relieving medications:

These types of drugs are taken during migraine attacks and are designed to stop symptoms that have already begun. These are taken as soon as symptoms of a migraine occur. It may help if you take rest or sleep in a dark room after taking them:

Nonsteroidal anti-inflammatory drugs (NSAIDs):

• Ibuprofen or aspirin may help relieve mild migraines.
• Combination of acetaminophen, aspirin and caffeine also may ease moderate migraines

Side effects: can lead to ulcers, gastrointestinal bleeding and rebound headaches.

Triptans:

Used for severe migraine attacks

• Sumatriptan, rizatriptan
• Naratriptan, zolmitriptan
• Almotriptan, frovatriptan and eletriptan 

Side effects: nausea, dizziness and muscle weakness

Contraindications: They aren't used in strokes and heart attacks

Ergot derivatives:

Used for pain lasting for more than 48 hours

• Ergotamine 
• Dihydroergotamine  

Anti-nausea medications:

Used for migraines associated with nausea or vomiting

• Metoclopramide
• Prochlorperazine

Butalbital:

It is a sedative which is used in combination with other drugs for migraine attacks

• Combination of butalbital with aspirin or acetaminophen
• Combination with caffeine or codeine

Side effects: Rebound headaches and withdrawal symptoms so shouldn't be used frequently

Opiates:

Medications containing narcotics, particularly codeine, are sometimes used to treat migraine pain when people can't take triptans or ergot.

Side effects: Habit-forming and patients are usually addicted

Preventive medications:

These drugs are taken daily on a regular basis, to reduce the severity or frequency of migraines. Are used when two or more debilitating attacks a month occur and if pain-relieving medications aren't helping or symptoms include a prolonged aura or numbness and weakness

Cardiovascular drugs:

• Beta blockers: Commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines.
• Calcium channel blockers: Verapamil also may be helpful in preventing migraines and relieving symptoms from aura.
• Antihypertensive medications: Lisinopril and candesartan are useful in reducing the length and severity of migraines.

Side effects: Dizziness, drowsiness or lightheadedness

Central Nervous System drugs:

• Tricyclic antidepressants: Amitriptyline, nortriptyline and protriptyline
• Selective serotonin reuptake inhibitors (SSRIs) and serotonin and nor epinephrine reuptake inhibitors (SNRIs): Venlafaxine may be helpful in preventing migraines.
• Anti-seizure drugs: Divalproex and Topiramate, and Gabapentin
• Side effects: 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: Botulinum toxin type A is sometimes used for treatment of chronic migraines.