Pain-Managing and Preventive Medicine for Migraine

People tend to use the word “migraine” to describe any severe headache, but in terms of a migraine there must be specific physiological changes within the brain. These changes lead to the characteristic symptoms, such as pain, of the migraine.

Most of the time, a migraine headache will include sensitivity to smells, sound, and light as well as possible vomiting and/or nausea. The headache will frequently involve only one side of a person’s head, although it can also be bilateral, meaning it affects both sides. Migraine pain is commonly described as pounding or throbbing and can worsen with physical exertion. As such, knowing which medicine for migraine to use can help significantly.

Medicine for Migraine

Selecting the right strategy for managing migraines will depend on the severity and frequency of these headaches, other medical conditions you suffer from, and how much disability the headaches cause.

Certain medicine for migraine isn’t suggested for those who pregnant or breastfeeding. Some other shouldn’t be taken by children. Your doctor will help you sort through migraine treatment options to find the right one.

For the best results at relieving your migraine, take your pain-relieving drugs at the first sign of a migraine. It can also help to rest in a dark room.

Pain-Managing Medicine for Migraine

Medicine

Description

Painkillers

Painkillers or pain relievers may be specifically marketed to treat migraines or general painkillers for everyday situations. Specific migraine painkillers, like Excedrin Migraine combine the acetaminophen with caffeine and aspirin, but don’t work for severe migraines.

For mild migraines, you can try acetaminophen (Tylenol), NSAIDs (nonsteroidal anti-inflammatory drugs), aspirin, or ibuprofen (Motrin IB, Advil). Indomethacin is a prescription pain reliever that you can also get as a suppository.

Side effects: If you take painkillers for too long or too often, you may develop medication-overuse headaches, gastrointestinal bleeding, or ulcers.

Triptans

Triptans promote blocking of pain pathways as well as constriction of the blood vessels within the brain. They are able to relive the pain as well as other migraine symptoms.

Some examples are eletriptan (Relpax), frovatriptan (Frova), zolmitriptan (Zomig), naratriptan (Amerge), almotriptan (Axert), rizatriptan (Maxalt), and sumatriptan (Imitrex). You can find them as tablets, sprays, and injections. Another option is Treximet, a combination of naproxen sodium and sumatriptan.

Side effects: These include muscle weakness, drowsiness, dizziness, and nausea. You shouldn’t take triptans if you have a risk of heart attack or stroke.

Ergots

These combine ergotamine and caffeine tend to work best if your pain lasts over 48 hours. It can worsen certain side effects, such as vomiting and nausea or lead to a headache from medication-overuse.

Dihydroergotamine,one ergot derivative, tends to have fewer side effects and you can get it as an injection or a nasal spray.

Anti-nausea medications

This medication is usually combined with other medications as it focuses on the symptom of nausea. Common choices include prochlorperazine (Compro), metoclopramide (Reglan), and chlorpromazine.

Opioid medications

These can contain narcotics like codeine and are used for migraine headache if you can’t take ergot or triptans. Because they are addictive, they are a last resort.

Glucocorticoids (prednisone, dexamethasone)

These may be combined with other medicine for migraine as a method of relieving pain. They shouldn’t be used frequently because of steroid toxicity risk.

Preventive Medicine for Migraine

People who have frequent migraine headaches may be prescribed preventative drugs to help reduce the intensity and frequency of the headaches. You take these drugs daily (or on a regular basis) one kind alone or with others. Sometimes it takes a few weeks to months to notice effects. These are usually used for other conditions, but work for migraines.

Medicine

Description

Beta blockers

These are usually prescribed to treat high blood pressure and decrease the effect of stress hormones on blood vessels and the heart. They can also reduce the intensity and frequency of migraines.

Options include timolol (Blocadren), propranolol (Inderal), nadolol (Corgard), metoprolol (Toprol XL), atenolol (Tenormin).

Side effects: These include depression, insomnia, dizziness when standing, nausea, and fatigue.

Calcium channel blockers

These are also for blood pressure and they moderate the dilation and constriction of blood vessels and can help with migraine pain.

Examples are verapamil (Verelan, Isoptin, Covera, Calan), nimodipine (Nimotop), and diltiazem (Tiazac, Dilacor, Cartia XT, and Cardizem).

Side effects: These include constipation, dizziness, weight gain, and low blood pressure.

Antidepressants

These affect the levels of chemicals in the brain, such as serotonin.

Options are venlafaxine (Effexor), sertraline (Zoloft), paroxetine (Pexeva, Paxil), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), fluoxetine (Sarafem, Prozac), and amitriptyline (Endep, Elavil).

Side effects: These include decreased libido and weight gain.

Anticonvulsants

These prevent seizures and are medicine for migraine as they calm overactive nerves within the brain.

Examples are zonisamide (Zonegran), valproate (Depakene), topiramate (Topamax), tiagabine (Gabitril), pregabalin (Lyrica), levetiracetam (Keppra), gabapentin (Neurontin), and divalproex sodium (Depakote).

Side effects: These include blurred vision, dizziness, sleepiness, weight gain, diarrhea, vomiting, and nausea.

Botulinum toxin type A (Botox)

These injections within the neck or forehead muscles may help treat chronic migraines if other medicine for migraine doesn’t work. They are expensive as you must repeat them every three months.

Things to Watch Out For

  • If you take an over-the-counter painkiller, check the instructions and follow the dosage carefully.
  • Those under 16 should only take aspirin if their doctor suggests it. Adults with a history of liver, kidney, or stomach problems should not take ibuprofen or aspirin.
  • Anytime you frequently take painkillers, your migraines can worsen, leading to medication overuse headache.

When to See a Doctor

You should call 911 in the following cases:

  • You have the worst headache ever.
  • You have movement, vision, speech, or balance problems and haven’t experienced those with migraines in the past.
  • Your headaches suddenly start.

Make an appointment or talk to your doctor in the following cases:

  • The pain or headache pattern changes.
  • Previously helpful treatments don’t work anymore.
  • There are migraine side effects.
  • You have migraines while taking birth control.
  • The headaches get worse when lying down.
 
 
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