There are a number of treatment options available for migraines. Although migraines cannot be cured, treatments aim to control the symptoms and prevent future episodes. Patients may benefit from immediately treating their migraine as soon as symptoms appear. This may lessen the severity of the headache.
Simple treatment methods for migraines include:
Resting in a quiet and darkened room. During a migraine, patients are often sensitive to noise and light. Silence and darkness may lessen the severity of migraine symptoms.
Drinking fluids. This prevents dehydration, especially after vomiting.
Placing a cool cloth on the head.
Prescription and over–the–counter medications may also be used to prevent migraines, stop the progression of a migraine and relieve symptoms.
Prescription and over–the–counter headache medications may also be used to prevent migraines, stop the progression of a migraine and relieve symptoms:
Beta blockers. These drugs decrease the workload of the heart and lower blood pressure.
Calcium channel blockers. These drugs increase the flow of oxygen-rich blood to the heart, lower blood pressure and reduce the workload of the heart.
Other antihypertensives. These drugs are commonly used to treat high blood pressure.
Anticonvulsants. These drugs are commonly used to control seizures.
Selective serotonin reuptake inhibitors (SSRIs). This class of antidepressants is most commonly used to treat depression. Antidepressants, however, may increase the risk of suicidal thinking and behavior in children and adolescents. As a result, the U.S. Food and Drug Administration recommends that people being treated with these drugs be closely monitored for unusual changes in behavior.
Antihistamines. These drugs are commonly used to treat allergic reactions.
To be effective, these medications must be taken every day. They are frequently recommended for patients who experience three or more migraines a month. Although they may be recommended for some patients, they are less helpful and tolerable in patients with only occasional migraines.
Medications that can stop the progression of migraines or reduce their severity include:
Triptans
Ergot alkaloids
Isometheptene
Patients who experience migraines with aura (temporary visual changes that precede a migraine) may benefit from taking these medications when warning symptoms occur. However, many of these medications are not safe for everyone. Drugs in this group may cause the blood vessels to constrict. As a result, they should not be taken by patients with heart disease or those at risk for a heart attack, unless recommended by a physician.
A variety of drugs may be recommended to reduce pain, nausea or emotional stress related to migraines. Medications given to treat these symptoms include:
Anti-emetics to relieve nausea
Sedatives to reduce anxiety
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to reduce pain and inflammation
Acetaminophen to relieve pain and reduce fever
Narcotic analgesics (opioids) to relieve pain or inflammation
Medications used to treat migraines have variable effectiveness in different people. In many cases, a number of medications may be tried before an effective drug, or combination of drugs, is found.
As an alternative to drug therapy, patients may choose to take feverfew, MIG-99 (an extract of feverfew) or butterbur. These are herbs commonly used to treat migraines. Although their effectiveness has not been proven, some studies support their use. Riboflavin (vitamin B–2) and magnesium sulfate may also be helpful. Patients should receive their physician’s approval before taking herbs, supplements or other complementary and alternative treatments for their migraines.
Additional treatment methods include:
Biofeedback. This method uses electronic monitoring devices to teach people how to consciously regulate their bodily functions through relaxation or imagery. Migraine suffers may use this technique to stop an attack or reduce its symptoms.
Self-hypnosis exercises. This method requires a patient to self-induce a state of hypnosis (an altered state of consciousness). It may be used to control muscle contraction and the swelling of blood vessels in patients with migraines.
Cognitive behavioral therapy. This technique, in which patients identify negative thought patterns and replace them with positive ones, may benefit people with chronic pain.
Cryotherapy. Application of cold, such as compresses or an ice pack, can numb nerves and increase the patient’s pain threshold.
Electrical therapy. Techniques such as occipital neurostimulation (ONS), in which electrodes are placed near the base of the skull in minimally invasive surgery, have been used to ease severe migraines.
Acupuncture or acupressure. Some people have found these Eastern treatments helpful.
People respond differently to treatment. Some may require little or no treatment and others may require the use of several medications or techniques, or in some cases, occasional hospitalization. Patients are encouraged to contact their physician when treatments that were previously effective are no longer helpful.
In addition to taking medications, patients may reduce the frequency of migraines by avoiding factors that trigger the headaches. Patients may identify these triggers by keeping a headache diary. To compile this journal, patients should record certain information after each migraine occurs, including:
When the migraine occurred
How severe the migraine was
Additional symptoms experienced with the migraine
What was eaten before the migraine occurred
Sleep patterns
Menstrual cycles
Other common prevention methods include:
Avoiding cigarette smoking
Avoiding caffeine and alcohol
Avoiding or reducing medications containing estrogen
Exercising regularly
Maintaining a regular diet and sleep pattern
Using relaxation techniques, such as progressive muscle relaxation or meditation
