Migraines are more than a bad headache. As nearly 30 million Americans can attest, the throbbing pain of a migraine can be debilitating, lasting from a few hours to several days. The condition can be aggravated by light, sounds, odors, exercise, even routine physical activities. Nausea, with or without vomiting, may occur.
Fortunately, treatment helps most people who have migraines.
Doctors may recommend preventive medications for patients who have two or more debilitating episodes a month. Typically the medication is taken at regular intervals, often daily. Antidepressants, anti-seizure medications and cardiovascular drugs may help prevent migraines.
Infrequently, nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, others) may help. Injections of botulinum toxin type A (Botox) is an alternative for people who can’t take or don’t respond well to preventive medications. However, this use of Botox for migraine prevention is not approved by the Food and Drug Administration.
Pain relief drugs for migraines should be taken as soon as symptoms begin. Mild migraines may respond to NSAIDs or aspirin. A moderate migraine may respond to a nonprescription combination of a drug containing acetaminophen, aspirin and caffeine. Other drug categories used to treat pain include triptans, which mimic the action of the brain chemical serotonin; anti-nausea and related drugs; and ergots, which were used for decades before the more recent introduction of triptans.
Some patients find relief from alternative therapies. The National Institutes of Health has concluded that acupuncture may help control headaches. A study in the journal Headache showed that a combination of yoga, breathing exercises and relaxation techniques reduces migraine frequency and pain.
Some find benefit in herbal remedies, such as butterbur, which appears to be safe if taken for a short period to prevent migraines. In addition, the supplement coenzyme Q10 appears to reduce migraine frequency for some. Patients who consider alternative therapies should consult their physician about the pros and cons and to prevent any drug interactions.
The September issue of Mayo Clinic Health Letter provides more information on treatments to prevent migraines and stop the pain.
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