Migraine. It’s not just a headache. If you’ve ever experienced one, you know the throbbing pain, agonizing nerve sensitivity and nausea that makes it difficult, even impossible, to function. Some severe migraines include visual auras and muscle weakness. They can last hours or days.
No, migraine is not just any headache, and neurologists are learning more about the complex patterns of nerve excitation that trigger the avalanche of a migraine and how to stop it. They are also learning more about why some people experience migraine and others don’t.
Currently, there are two ways to treat migraine: stopping the pain (abortive) and preventing the attack.
Pain relief medications for migraine range from aspirin and ibuprofen to triptans (which constrict blood vessels and block pain pathways in the brain) to Ergotamine and caffeine combination drugs. These may be used in conjunction with anti-nausea drugs if needed. Rarely, opioids or glucocorticoids may be prescribed for patients who cannot tolerate the more common drugs.
Preventive medications for migraines include beta blockers and calcium channel blockers (typically used to treat high blood pressure), tricyclic antidepressants, the serotonin and norepinephrine reuptake inhibitor venlafaxine and the angiotensin-converting enzyme inhibitor lisinopril. Preventive medications may also reduce symptoms should a migraine occur.
Anti-seizure medications and Botox have also been used successfully to prevent migraines, as well as Naproxen, a non-steroidal anti-inflammatory drug (NSAID).
BOTOX® has been FDA approved for the treatment of certain types of headaches and in many cases insurance companies will cover the use of BOTOX® for headache treatment.
Your neurologist can help determine which medications will work best for you with the least risk of side effects. Complementary therapies such as muscle relaxation and acupuncture can also help reduce the incidences and pain of migraines.