Treatment Options in Migraine Management
For those who suffer with migraine headaches, finding effective prevention and treatment options is vital. Bad migraine days can be completely debilitating, taking time away from work, family, and other obligations. These are things that cannot be regained. A combination of therapies including pain killers, cardiovascular drugs, antidepressants, cognitive behavioral therapy, vitamins and minerals, herbs, or other natural treatments can help improve quality of life for migraine patients.
Migraine pain is caused by spasm and inflammation of the blood vessels. Therefore, traditional pain medications may not be as effective for this type of pain. Some people can get relief with medications such as ibuprofen or naproxen due to the anti-inflammatory effects. A class of drugs called “triptans” are the main abortive therapy prescribed for migraines. These include such name brand medications as Imitrex, Zomig, and Maxalt. They work through a mechanism of stopping the spasms and thus alleviating migraine pain. Sometimes physicians may recommend taking both a “triptan” medication along with an anti-inflammatory for the greatest pain relieving benefit.
This class of medications is primarily used for preventative therapy in migraine treatment. Most commonly a non-selective beta blocker, such as propranolol, will be prescribed. This type of beta blocker works on the blood vessels, which again is the cause of migraine pain. Calcium channel blockers, like verapamil, may also be used if a beta block is contraindicated.
There are several classes of antidepressants. The ones that have been proven to help most in migraine prevention are the tricyclics. Primarily, doctors prescribe amitriptyline, and less frequently nortriptyline. There is also some new research that suggests Effexor XR, a serotonin and norepinepherine uptake inhibitor, may also be helpful in migraine prevention. These medications work by affecting serotonin levels.
Cognitive Behavioral Therapy
This type of therapy is not widely known. It involves a type of psychotherapy in which negative associations with migraines and migraine pain are replaced with positive emotions. This is especially helpful for patients who have a lot of contraindications or adverse effects to medications and for children who cannot take many medications.
Some people prefer a more organic, non-pharmaceutical approach to migraine treatment. Cognitive behavioral therapy can be used as mentioned above. In addition, there are vitamins and minerals, as well as herbs that can be used for migraine therapy. Magnesium deficiency has been linked with migraine headaches, so using a magnesium supplement may be beneficial. Also, Butterbur is a supplement that has the ability to reduce spasms and inflammation, which are two main causes of migraines. Peppermint oil can be applied directly to the forehead or temple areas for calming and numbing. Lastly, ginger is known to aid with muscle contractions, inflammation, and nausea to help with migraine symptoms.
The therapies and treatments described here illustrate a variety of ways to approach migraine prevention and alleviation. Many patients find a combination of therapies to be the most effective approach. The challenge is finding the right mix for each individual. Trial and error is often the only way to determine a successful treatment plan, but working closely with a neurologist you trust can get you on the path to migraine freedom. Be sure to consult your physician before beginning any new medications or supplements.