First it’s a dull ache. Then your head begins to throb, followed by a nauseous feeling and a desire to lie down in a dark, quiet room—for hours. With that kind of suffering, you might consider turning to prescription medications for help to prevent your migraine. But how well do the meds work?
Researchers recently reviewed hundreds of studies to find out which medications are best at preventing migraines with the fewest side effects. The researchers found that all the various types of drugs seemed to be about equally effective—which is to say, not very. Depending on the drug, as few as one or two out of five patients had their migraines reduced by more than 50 percent, possibly because none of the migraine drugs in use today were designed specifically to prevent migraines. All were created to treat other conditions, like seizures or depression. The drugs that performed the best, according to the review: beta-blockers and angiotensin inhibitors, used primarily for high blood pressure and other heart problems.
The price of prevention
Worse, many patients who were prescribed medications experienced side effects so unpleasant that they opted to stop taking them, preferring instead to withstand their migraines. The reported adverse effects included weight gain, tremor, diarrhea, weakness, hair loss, tingling, sleepiness, an increased risk of diabetes and sexual side effects. The drugs most likely to cause these side effects were topiramate, anti-seizure medications and anti-depressants.
Experts suggest that the study highlights the need for better migraine medications. But in the meantime, if your meds aren’t giving you relief, or if you’re troubled by side effects, don’t suffer in silence. Ask your doctor what other options are available for you.
The 411 on migraines
Migraines affect more than 37 million Americans, with women being affected more than men. They can come on at any time of the day, though most start in the morning. And while the exact cause of migraines isn’t fully understood, many researchers believe inflammation and the swelling of blood vessels in the brain contribute to the pain.
Sufferers tend to feel throbbing, stabbing pain on one side of the head, with pain and pressure behind the eyes and around the temples. Migraine headaches can also cause vomiting, sensitivity to light and sound, even temporary loss of vision. And some can last up to 72 hours.
What else can I do?
If the benefits of prescription migraine prevention don’t outweigh the costs for you, there are other things you can do to get relief from migraine pain.
- Know your triggers—Keep a headache diary to track the time of day your headache started, where you were and what you doing, what you ate or drank 24 hours before the migraine attack, and, if you’re female, the timing of your periods. Try and notice any patterns you see. Learning to identify your triggers can help you stop migraines before they start.
- Go au naturel—Butterbur is considered to be the most effective nutritional remedy for migraines. Like feverfew, also recommended for natural migraine prevention, it works to reduce the inflammation and blood vessel constriction believed to cause migraine pain. Supplements can also help. Magnesium has been shown to have some migraine-fighting power and can be found in whole grains, non-citrus fruits and dark green vegetables or as a supplement. And riboflavin, or vitamin B2 has been shown in some studies to reduce the number of migraine attacks by half.
- Try Botox—Believe it or not, the wrinkle-reducer has also been touted as an effective way to temporarily prevent chronic migraines. Botox injections work to decrease muscle tension and contraction by paralyzing the muscles thought to be associated with migraine pain.
