Migraine The Missing Piece

How is Migraine Treated?, In addition to advising patients to avoid their specific triggers, physicians may recommend preventive medications or behavioral therapies to prevent migraine headaches. When migraines do strike, acute medications can also be used.

Preventive Medications The daily preventive medications prescribed for migraine headache include:

* Tricyclic anti-depressants (such as amitriptyline) * Beta-blockers (propranolol or timolol) * Calcium channel blockers (verapamil) * Anti-convulsants (Depakote, also known as divalproex sodium; Topamax, or topiramate; Neurontin, or gabapentin) * Alternative treatments (vitamin B2, magnesium) * Vasodilators (methysergide maleate, or Sansert) * Hormone therapy (for women with menstrual migraine)

Behavioral Treatments Research has shown that some behavioral treatments can help prevent stress-related migraine. These treatments include various forms of relaxation training, including: Thermal and electromyographic (EMG) biofeedback techniques may help patients develop a degree of voluntary control over their blood pressure, heart rate, temperature, muscle tension, brain waves and body temperature.

* Cognitive-behavioral therapy (stress management) * Regular exercise, such as swimming or walking, can reduce stress and the frequency and severity of migraines.

Abortive Medications These medications are given once the symptoms of a migraine have appeared. Sometimes a simple ice pack can dull the pain of a migraine, but acute migraine headaches usually require one or more over-the-counter and/or prescription drugs:

* OTC medications: These include aspirin, ibuprofen, naproxen or acetaminophen. Some of these products are combined with aspirin and caffeine. * Nonsteroidal anti-inflammatory drugs and other analgesics including narcotics and non-narcotics * Serotonin agonists: (sumatriptan [Imitrex], zolmitriptan [Zomig], naratriptan [Amerge], rizatriptan [Maxalt]), almotriptan [Axert], eletriptan [Relpex] and frovatriptan [Frova]). These medications cause vasoconstriction and are therefore contraindicated in people who have uncontrolled high blood pressure, angina pectoris (chest pain due to clogged arteries), heart attack, stroke or basilar migraine. * Vasoconstrictors (Migranal [ergotamine], Cafergot [ergotamine/caffeine]): Useful in the painful dilation stage of a migraine.

The medications used acutely for migraine have varied side effects but are considered safe when used under a physicianÕs supervision. To avoid side effects, the dosage should be kept at minimum, and the medication discontinued as soon as possible.