Migraine Overview
Migraine is a severe type of headache that causes debilitating symptoms, including throbbing head pain, nausea, and sensitivity to light or noise. It affects about 12% of Americans.
Because migraine impacts everyone differently, there is no one-size-fits-all treatment. Various options are available to help manage symptoms, prevent episodes, and improve quality of life. Treatment plans often include medications, therapies, lifestyle modifications, and home remedies, customized to each individual's symptoms, triggers, and overall health.
Medications for Acute Migraine
Acute migraine treatment focuses on relieving symptoms during an active attack. Medications used include:
- Pain medications: Over-the-counter options like Tylenol (acetaminophen) and NSAIDs such as Advil (ibuprofen) and Bayer (aspirin) are commonly used. Stronger pain medications may be prescribed if needed.
- Triptans: These are anti-migraine drugs that reduce headache symptoms. Available as pills or nasal sprays, examples include Imitrex (sumatriptan) and Zomig (zolmitriptan).
- Ergot alkaloids: Used for severe migraine attacks, with Migranal (dihydroergotamine) being a common prescription.
- Antiemetic drugs: To manage nausea and vomiting associated with migraine, medications like Reglan (metoclopramide) and Compro (prochlorperazine) are used.
Medications to Prevent Migraine
For individuals experiencing frequent or severe migraines (chronic migraine), preventive treatments may be recommended. These include:
- CGRP inhibitors: These drugs block the CGRP protein involved in pain signaling. Options include injectable treatments like Aimovig (erenumab) and oral medications like Ubrelvy (ubrogepant) and Nurtec ODT (rimegepant).
- Anticonvulsive drugs: Originally developed for seizures, medications like Topamax (topiramate) can also prevent migraines.
- Antihypertensive drugs: Beta blockers like Inderal (propranolol) and angiotensin receptor blockers like Atacand (candesartan) are sometimes used.
- Certain antidepressants: Medications such as Amitriptyline and Effexor (venlafaxine) may help decrease migraine frequency.
- Botox injections: Botox (onabotulinumtoxinA) can help reduce migraine frequency and may be administered every three months.
Neurostimulation
Neurostimulation uses electric currents or magnetic waves to treat chronic migraine. It is a noninvasive therapy that stimulates pain-associated areas of the brain. Options include:
- Vagus nerve stimulation (VNS): A handheld device delivers treatment to the neck.
- Transcranial magnetic stimulation (TMS): Magnetic pulses are delivered to the back of the head.
- Supraorbital stimulation (SONS): Electrodes or a wearable device send electrical signals to the temples.
- Sphenopalatine ganglion (SPG) stimulation: Electrical stimulation is directed to an area above the upper jaw.
Behavioral Treatments
Behavioral factors like stress, sleep deprivation, and skipping meals can trigger migraines. Treatment options include:
- Cognitive behavioral therapy (CBT): A mental health professional helps modify thought patterns, encourage healthy habits, and manage stress.
- Biofeedback: Electrical sensors monitor physiological signs like heart rate and muscle tension, helping you learn relaxation techniques to manage symptoms.
Lifestyle Recommendations
Adopting healthy habits can help prevent migraine episodes. Recommended lifestyle changes include:
- Maintaining a regular exercise routine
- Drinking sufficient water daily
- Getting at least seven hours of uninterrupted sleep each night
- Limiting alcohol and tobacco use
- Spending time outdoors
- Avoiding food triggers such as chocolate, cured meats, and aged cheeses
- Managing stress through enjoyable activities and social interactions
A Quick Review
Migraine is a neurological disorder that causes intense, painful headaches and other symptoms. While there is no single cure, various combinations of medications, neurostimulation therapies, behavioral treatments, and lifestyle changes can help manage the condition and improve quality of life.
