Treatment of migraine

Trigger avoidance

Probably the best possible treatment for a chronic migraine is trigger avoidance! Patients can attempt to identify and avoid factors that promote or precipitate migraine episodes. In most cases, a general dietary restriction has not showed to be an effective approach to treating migraine.

Symptomatic control

Migraine sufferers have noticed that a cold or hot shower, a wet washcloth, or less often a warm bath and resting in a dark and silent room may be as helpful as medication for them, but both should be used when needed. Pain killers are recommended by most of the experts. The problem is that many patients avoid taking the medications when the attack is beginning, hoping that it will go away. This is wrong because treating the attack at the onset can often abort it before it becomes serious, and can reduce the frequency of subsequent attacks in the near-term.

Over-the-counter abortive medications

The first line of treatment should be over-the-counter abortive medication.
Doctors often recommend simple analgesics, such as paracetamol, Aspirin and caffeine. They may provide some relief, although they are not effective for most sufferers.

Narcotic pain killers

Narcotic pain killers, codeine, morphine or other opiates are proven to provide variable relief. However they have several possible side effects, such as the possibility of causing rebound headaches or analgesic overuse headache, and the risk of addiction.

Selective serotonin receptor agonists

Selective serotonin receptor agonists are becoming the therapy of choice for severe migraine attacks that cannot be controlled by other means. They are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70-80% of patients. They have few side effects if used in correct dosage and frequency.

Some members of this family of drugs are:

• Sumatriptan (Imitrex®, Imigran®)
• Zolmitriptan (Zomig®)
• Naratriptan (Amerge®, Naramig®)

Preventive drugs

Patients who have more than two headache days per week are usually recommended to use preventatives and avoid overuse of acute pain medications. The most effective prescription medications include several classes of medications such as beta blockers, antidepressants and anticonvulsants.

Physical therapy

According to many physicians, exercising for 15-20 minutes per day is helpful in reducing the frequency of migraines. Massage therapy and physical therapy are often also very effective forms of treatment in reducing the frequency and intensity of migraines. Patients should also be aware of the fact that deep massage can trigger a migraine attack in a person who is not used to such treatments.

Herbal supplements

• Butterbur (Petasites hybridus) rhizome extract
• Cannabis
• Supplementation of coenzyme Q10
• The plant feverfew (Tanacetum parthenium)
• Magnesium citrate
• Kudzu root (Pueraria lobata)