What Treatment Is There for Migraine?

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[MUSIC] Part of the reason it's so important for the patient to fully disclose how frequently they're having any kind of headache, is that really guides their treatment. Patients who are having frequent headache, which varies for patients, but you could say more than one's a week, typically, should be on daily preventive medication for their migraines.

Migraine prevention is sorely under utilized. The literature shows that approximately 40% of patients with migraine should be on it to qualify for it, and only approximately 12% are. And the problem with that is that you end up taking too many pain medications and that actually escalates your headache problem.

It's a common trap that patients get into. We are used to call it rebound headache, now we call it medication overuse headache. And it's where patients are taking pain medicine, essentially to prevent their headaches. They know that if they take it early it will keep them from getting a bad headache.

So their thinking is actually on the right track, that they need to be medically preventing their headaches, but they are not going about it the right way or in a safe fashion. It's not safe to take pain medications on a frequent basis. Interestingly, even the over-the-counters have been shown not to be safe.

Now probably most people know you don't wanna take too much Tylenol, it can damage your liver, or if you take too much Advil it can irritate your stomach. But it's becoming abundantly clear that it's much more dangerous than that. For example, there's literature that if you take NSAIDs such as Advil too frequently, it increases your risk of heart attack and stroke, even in otherwise healthy patients.

So the treatment of frequent headache, frequent migraine, is not frequent pain medication. It's a preventive medication. Now, a common misconception about preventive medications is that they need to be taken for the rest of your life, and that's not the case. It's typically about six months, maybe a year, and what that does is that it kind of breaks this migraine cycle that you're in, breaks the pain cycle, helps your brain to calm down, to stop releasing so much pain chemical, and then you don't need it anymore.