Migraine Headache Treatment

Migraine Headache Treatment

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    Migraine medications have both a positive and negative effect on the postdrome phase of migraine headaches. Medications like beta-blockers and calcium channel blockers help to prevent migraines. Medications like tricyclic antidepressants help in managing your headache. While these medications help avoid a strong migraine they can also add to the hung-over feeling of the postdrome phase. Additionally, medications that deal with estrogen levels in women, like birth control, should be avoided since they tend to worsen migraine headaches.

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    A , Neurology, answered
    Rescue medications should be available for those infrequent occasions when other therapies haven't helped. Common anti-migraine rescue agents that can be used in children and adolescents include the antihistamines diphenhydramine (Benadryl) and hydroxyzine (Vistaril, Atarax). Opioid or narcotic analgesics are rarely helpful for migraine and should generally be avoided in children and adolescents.
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    A Neurology, answered on behalf of
    What should I ask my doctor about migraines?
    Find out the exact diagnosis and details of your treatment plan, says Mark Green, MD, director of the Center for Headache and Pain Medicine at the Mount Sinai School of Medicine. In this video, he offers other suggestions.
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    A answered

    Triptans were the miracle of the late 1980's and 1990's. Just because one triptan has failed, does not mean that another will not work. The are admonitions to triptan therapy such as significant heart disease, significant possible allergic reactions and although rare can occur. If you have failure with one triptan, try another. Trexomet has naproxen with Imitrex in the tablet. This may result in better and longer lasting relief. A lot of clinical trials have been done on this combination triptan and it has been shown to be very effective. For people who do not respond to triptans at all, there are other alternatives including ergots, prophalaxysis, and pain medications.

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    A , Neurology, answered
    In pill form, triptans such as almotriptan (Axert), eletriptan (Relpax), rizatriptan (Maxalt), sumatriptan (Imitrex), or zolmitriptan (Zomig) can stop a migraine headache within two hours, provided the drug is taken when the headache is still mild. Doctors stress the importance of taking the drug as soon as possible after your symptoms begin, because as the headache progresses, migraine slows down the function of the gastrointestinal system so the medications aren't absorbed as well.

    Although naratriptan (Amerge) and frovatriptan (Frova) can take nearly twice as long to work, they have fewer side effects and are more effective in preventing the headache's return within 24 hours.

    Sumatriptan and zolmitriptan come in nasal sprays that cut the medication's absorption time to an hour, making them a good choice for more intense migraine headaches.

    An injectable form of sumatriptan can provide relief in as little as 15 minutes. It's available in an automatic injector, allowing individuals to self-administer the drug, although many are hesitant to do so. It is also available in a needle-free version, called Sumavel.
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    A , Neurology, answered
    Studies evaluating prevention drugs in children are limited. Drugs that effectively prevent migraine that have been directly tested in young people include propranolol (Inderal); the antidepressants amitriptyline (Elavil) and trazodone (Desyrel, Beneficat); and the anti-seizure drugs valproate (Depakene, Depacon) and topiramate (Topamax).

    A study that compared migraine prevention in 120 children ages 3-15 years treated with either propranolol or valproate found that headache frequency was reduced by at least half in seven of ten children treated with either valproate or propranolol. A small study comparing headache improvement in 48 children with migraine treated with either valproate or topiramate likewise found that both treatments provided similar results. The anti-seizure drug levetiracetam (Keppra XR) was effective in preventing migraines in two studies testing small numbers of youngsters (19 youth in one study and 20 in another); however, both valproate and topiramate have been more extensively studied in younger patients than has levetiracetam.
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    A , Neurology, answered
    Migraine headache medications can be divided into four categories:
    • Acute therapy: Treats a specific headache episode
    • Prevention therapy: Reduces the frequency and severity of future headaches
    • Nausea treatments: Used to reduce severe nausea and vomiting during a headache
    • Rescue therapy: Taken on those infrequent occasions when other therapies don't work
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    A , Neurology, answered
    If your usual acute treatments don't work for a particular migraine headache, you might need a rescue therapy. Many medications can be used for rescue. Some of the more common ones are: chlorpromazine (Thorazine); a combination of isometheptene mucate, dichloral-phenazone, and acetaminophen (Midrin); and hydroxyzine (Vistaril). Opioid pain medications are often not helpful, and should be used sparingly because of a higher risk for developing rebound headaches relative to other medications.
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    A , Neurology, answered
    Single doses of opioids can be used cautiously as rescue therapy -- repeated dosing should be avoided. Newborns have a limited ability to break down and metabolize opioids such as morphine. Therefore, repeated dosing in mom may result in a build-up of high morphine levels in the newborn. This may cause the baby to have a dangerously low heart rate and problems breathing.
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    Work with your doctor to come up with a plan for managing your migraines. Keeping a list of home treatment methods that have worked for you in the past also can help. When symptoms begin:

    If you take migraine medicine, take it right away Drink fluids, if you don't have nausea during your migraine Lie down and rest in a dark, quiet room, if that is practical

    Some people find the following useful:

    A cold cloth on your head Rubbing or applying pressure to the spot where you feel pain Massage or other relaxation exercises

    This answer is based on information from the National Women's Health Information Center.

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