Migraine attacks are not just a headache. They are part of a migraine disease, a neurological disorder, and they contain a variety of symptoms that can include intensive headache attacks, especially on one side of the head. Sensitivity to light, sounds and smells; Tingling or deafness in their arms and/or legs, mood changes and intense fatigue among other symptoms.
This chronic disease can be difficult to treat, but there are many different migraine treatments. We turned to Jessica Ailani, MD, FAHS, a neurologist and director of the Georgetown Headache Center, to learn more about treatment options for people with migraine diseases.
What types of treatments can I use for the beginning of the symptoms of a migraine stop? (Non -prescription, prescription)
Treatment at the beginning of migraine symptoms is called acute treatments. These range from over-the counter medication and treatments such as NSAIDS (non-steroidal anti-inflammatory medicines) such as aspirin, ibuprofen and naproxen to paracetamol and combination treatments such as aspirin/acetaminophen/caffeine to foreign exchange and prescription.
Some people find ice cream bag and cold rubs that are also helpful in an attack. Although there are not many studies that support this, it is common for people with migraine sickness to use ice on the head and neck during an attack.
If over -the -counter treatments are not effective, it is time to talk to your health service provider (HCP) about prescription medication.
Neuromodulation devices are a way to treat a migraine attack after the start, but may require a recipe. Devices work in different ways to reduce abnormal signal transmission in the brain that are involved during a migraine. FDA-clear devices for the acute treatment of migraine prevention include STNS (CEFALY), Remote Electrical Neuromodulation (Nerivio), STMS (E-Neura), Ecots (Relivion) and NVNS (Gammacore).
The most common prescription drug for migraines is a class known as a triptan. These are medication that you use as a need for an attack that works on the blocking of chemicals that are released during the pain phase of a migraine attack. Triptans can be tablets that swallow them, tablets that dissolve in their mouth or nasal sprays, and you are a self-injection.
The different forms are important because migraines can cause nausea and vomiting. If nausea or the feeling that you cannot eat or drink during an attack, it is important to use a medication through nose or through injection. Triptans should not be used for more than 10 days a month or you can cause something as a rebound headache or medication that have headaches (MOH). You don’t work late in a migraine attack either.
Another category of acute treatment are Gpanten. Pants are also used especially for migraine attacks and can be assumed as a tablet, oral, dissolvable tablet or nasal spray. They have fewer side effects than triptans and can be used in a wider range of populations, but for some people they may not be as effective as triptans. GPants block a protein called CGRP that is involved in a migraine attack. It has been shown that a panton works when it is absorbed during the Protromphase or Aura (before the pain of the migraine begins). It is not believed that GPants lead to back -up headaches and can be an advantage for people with more frequent attacks.
A third category of acute treatment are ergots. Ergots block a larger number of chemicals that are involved in migraines, so that they can sometimes be effective if other treatments are not the case. Ergots can be viewed as a nasal spray or injection and can work early or later in a migraine attack.
Are there treatments to prevent migraines? (Non -prescription, prescription)
In order to reduce the frequency of migraine attacks and improve disability, preventive treatment is used. Preventive treatment includes behavioral therapies, vitamin preparations, neuromodulation devices and medication that can be prescribed by your clinician.
Changes to the lifestyle should be taken into account for all people with migraines. This includes:
- Regular sleep and alarm plans
- Regular eating times
- Good moisture with water – drink water when you are thirsty
- Regular movement – move your body every day, even if you have headache attacks. Try to stretch on the spot or keep a gentle yoga pose.
- Regulate stress – meditate, practice deep breathing, make regular movement and exercise, journal, hear
Behavioral interventions can be used alone or in addition to medication to reduce the migraine frequency. The best examined behavioral techniques for reducing Frequently Migraine attacks include biofeedback, progressive muscle relaxation and cognitive behavioral therapy if they suffer from general fear or fear of their migraine attacks, or to cope with chronic pain.
Vitamin nutritional supplements that have good evidence of migraine prevention are riboflavin, magnesium and butterbur. Butterbur should be used under the instruction of an HCP, since the use of the wrong type is dangerous for your liver health. There are other supplements used for migraine prevention, but the studies are not so strong that they are effective.
Many medications are available to prevent migraines. There are migraine -specific treatments that block CGRP, which is a protein that is caused by migraines. Tablets that block CGRP can be specified daily or every other day. Injections of monoclonal antibodies that block CGRP can be administered every month or every three months. Tablets can be easier for some people, but a monthly or quarterly injection can be more convenient. To make a decision about which medication is best suited for you, it is a good idea to talk to your HCP and check potential side effects.
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There are also medication that are older and inexpensive because they have been able to effectively reduce the frequency of migraine for decades. This includes some blood pressure medication, some anti-an-for-an-for-an-to-S-medication and some specific antidepressants.
For people with chronic migraines (more than 15 migraine days per month for three months, for which eight days of headache have migraine properties), injections with onabotulinum toxin A (botox) are also a treatment option approved by the FDA. A trained injector follows a specific injection protocol to give the treatment every 12 weeks in order to reduce the migraine frequency and disability.
Finally, the neuromodulation devices mentioned above are mentioned.
When should I consider using preventive therapy?
If you have six or more migraines per month, you should consider starting preventive therapy.
You should also discuss preventive therapy with your HCP if you have two or more migraines per month and you lack work or life events. You do not have good acute treatment that works for attacks, or you have attacks with severe symptoms (e.g. muscle weakness during the migraine stop).
How can I determine which treatment will work for me?
At this point there is no good way to know which treatment will work for you without trying out different options and seeing what works.
Are there alternative therapies such as cognitive behavioral therapy (CBT), acupuncture or biofeedback that I should take into account?
There are a number of evidence that biofeedback reduces the number of migraines and how bad your migraine attacks are compared to people who do not take medication, but the evidence does not show that it helps more than medication or CBT, which also has robust evidence that support their effectiveness. Acupuncture has mixed evidence, but I recommend that patients who are interested (and can afford the costs and leisure) are trying to reduce the frequency of attack.
Should I go to headache specialists? How do I find one?
A good place for the treatment is at your basic care service provider or a general neurologist, since there are very few headache specialists in the USA if you feel that you do not improve or have several types of headache diseases or conditions that go hand in hand with your headache attacks, and a headache specialist would be the next step.
In order to find a headache specialist certified in headache medicine, you can search the United Council of Neurological Subspecialy Directory.
This educational resource was created with the support of Pfizer.
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