What treatment for migraine headaches actually works and what are my options? I get asked these two questions often, and I have spent A LOT of money trying to answer them.
The bottom line is that there is hope and there is a lot of help available now.
I figure that migraines affect all the systems of the body in some way. The neurological and blood vessels reacting causes the migraine. Our ever changing hormones, endocrine system, can be an unpredictable trigger.
And metabolic systems in the body are affected. My stomach cannot digest food around the time of the attack and I get ice cold.
The traditional treatment for migraine headaches, not as far back as drilling holes in our skulls, is medication.
There are also a lot of alternative tests and treatments out there in functional medicine like: live blood analysis test to detect protein assimilation and gluten intolerance, different diets and supplements, oxygen glucose systems to activate the brain, and the computerized listen system that analyses the meridian system.
There is also light and sound therapy, tens machines, new electronic devices. But finding what works to abort your migraines can be trial and error. I have not found alternative therapies to be much more than a band aid, but I pursued many in hope of a cure.
Having said that, I believe that there is more effective treatment for migraine headaches available now then there ever has been in the past. I think these are the best ones:
• Occipital Nerve Blocks
• Oxygen Therapy (especially effective for cluster headaches)
And on a lesser degree:
• I-V Therapy
Migraines are traditionally currently being treated by two approaches - abortive and preventive.
Abortive medications will stop an acute attack, while preventative medications will need to be taken daily as a prophylactic. The details are below, so keep reading.
According to the National Headache Foundation (NHF) “There is currently no test to confirm the diagnosis of migraine”. So is it still just trial and error after all these years? Yes it is.
Professor Lyn Griffith has discovered the TRESK gene, so hopefully in the very near future our treatment for migraine headaches will be simplified significantly. Read What Causes Migraines for more on the TRESK gene.
Some of the most common reasons for not being able to gain any control over your migraines most often relate to:
Two smartest things I've done:
- develop my own
treatment plan and a successful, effective pain management strategy for before, during and after the attack; and
- educate myself on the medications available to me, their
efficacy, residual and side effects, that provided me with the
information I needed to know on medication for migraine.
Much to my surprise, the NHF states that The Food and Drug Administration (FDA) have, to date, approved only three over-the-counter products to treat migraine:
“Excedrin® Migraine (a combination of aspirin, acetaminophen and caffeine) is indicated for migraine and its associated symptoms. Advil® Migraine and Motrin® Migraine Pain, both ibuprofen medications, are approved to treat migraine headache and its pain.”
Click here to learn more about getting your Doctor's instructions on taking your
migraine pain medications
and be prepared for your next attack. It really is best to have things
like that written down, especially when you can't think straight.
The FDA does not really recommend taking other anti-inflammatory prescriptions that are considered to be effective as treatment for migraine headaches due to their gastrointestinal side effects.
Also, because they are not actually effective, we sufferers tend to take more than the recommended normal doses which cause more serious problems like overdose. Overdose is one of my many feared words. I have also pushed the boundaries in my desperation for some pain relief.
The main goal or purpose of abortive therapy is to stop the attack once the process has already started. This is also called “acute” therapy. It is essential to take your medication as soon as you recognize your symptoms.
Once the episode has begun, if you experience nausea – like I do – the medications also come in nasal spray, rapidly dissolving tablets and self-injection forms. Discuss this with your doctor to determine which one you need.
The most effective thing I have found –so far - as treatment for migraine headaches that works for me is taking a Naramig at the first sign an attack is coming. And then ice packs and bed.
Naramig is a Triptan from the family of abortive drugs that specifically targets serotonin. They are all similar in action and chemical structure, but I have had very different reactions to them all. Yes – as you may already know - I’ve been through a few to find which one works.
For more details on Triptans please click on the link.
• Acetaminophen - isometheptene-dichloralphenazone (Midrin®). According to the National Headache Foundation there is some research that shows this is not “usually” an effective treatment for migraine headache. It is also known to cause rebound headaches if taken too often.
• Dihydroergotamine (DHE) is available by self injection and as Nasal Spray (Migranal). Ergotamine preparations are no longer available here in Australia, so they may not be in other countries either.
• Ergotamine Tartrate (Cafergot). My body severely rejected this one on a number of occasions by vomiting it up. It comes in tablet and suppository forms. Plus the caffeine in it kept me awake and revved up for two days - no sleep - and I could still feel the pain in the background. It was fun but not very effective.
• And the approved over-the-counter medications listed above.
** Please note that the medications can have very different names in different countries.
Please click here for a complete list of migraine medications that include drugs used for other symptoms like nausea.
Some attacks may just not be aborted and might require a narcotic analgesic. These are addictive so it is recommended that they are avoided for long term chronic sufferers.
The NHF says that medications belonging to the group of Phenothiazines are
non-analgesic options for treating severe migraine headaches, and for
attacks lasting more than 24 hours (called status migraine) corticosteroids may be used for their anti-inflammatory properties.
Prophylactic medication could be your next option if your recurring migraines are not controlled with acute or abortive treatments.
Typically having a severe migraine more than once per week is enough evidence to trial some preventive treatments with your doctor.
Unlike the acute abortive treatments, prophylactics are taken daily and not just with each attack. They work by preventing the whole process from starting by raising your migraine threshold. It’s also a good option if you have other medical problems that prevent you from taking acute abortive treatment.
Don’t be surprised if you are prescribed a medication for depression or epilepsy as these medications have also been found to work effectively against migraine.
Follow your doctor's instructions carefully with these and be patient to give them a fair trial time period. Research has shown that we forget to take prophylactics long term if they don’t work in the short term. Some take a while to take effect, so be patient, if you can!
Please click here for more information on migraine prevention and drugs. And like I said, remember that as of 2010 Botox is approved by the FDA as an effective treatment for migraine headaches.
Taking the right dose that is adequate for you is essential to making your treatment successful.
Acute - take it for long enough ( 3 separate migraines) to determine if it works.
Preventative – take it long enough to tell if it works. In some cases it might take 3 months.
Reduce the amount, after talking with your doctor if you experience side effects.
Try other alternatives if your migraines do not respond to the first line treatment of medications. These 3 classes of medications also have proven success in the treatment for migraine headache prevention:
Anti-depressants - regulate the brain chemical serotonin.
Anti-seizure medications - used to treat epilepsy and bipolar.
Anti-hypertensive medications - used for treating high blood pressure and heart disease are Calcium channel blockers and Beta-blockers.
Take your medication as soon as you feel your symptoms developing. Your medication will be more likely to be effective and abort the attack if you take it early.
I recently ignored my symptoms, yes I know, after 20 years I am a silly girl. I ended up with a 10 day migraine from Hell. Another not so gentle reminder to take my meds early. After all these years I still think it might just be a headache sometimes.
Ask your doctor what to do if the medications you are taking are not working. This is number one.
After discussing things with your doctor, ask your doctor for some alternative therapies that are known to work as effective treatment for migraine headaches.
He/she might suggest: Chiropractic work, acupuncture or acupressure, pain counseling or biofeedback. The NHF sites biofeedback and migraines as becoming the most widely used technique that is proven to “stop the attack or reduce its effects”.
Self hypnosis can also be “taught to control both muscle contraction and the swelling of blood vessels”. Being able to do things myself is cost effective and means I can do what I need to do proactively each day.
The most recent studies say that using a combination of traditional medicines and alternative therapies is our best shot at living migraine free.
Read one of these for more help:
Until next time, be well and be pain free.
Resource:. National Headache Foundation
Migraine Treatment Options
Treatment for Migraine Headaches: What Are My Options?