Migraine Headaches

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Questions to Ask Your Doctor about Migraines
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Abortive Treatment

Mild, infrequent migraines may be relieved using over-the-counter medication. Severe headaches with accompanying symptoms may require prescription medication.

During a migraine headache, people often prefer to rest or sleep alone in a dark, quiet room. Applying cold packs to the head or pressing on the bulging artery in front of the ear on the painful side of the head may provide temporary pain relief.

Analgesics (e.g., aspirin, ibuprofen, acetaminophen) provide symptomatic relief from headache pain and should be taken at the first sign of a migraine. They are most effective for infrequent migraines (less than 3 a month) and breakthrough headaches (i.e., headaches that occur despite using prophylactic medications).

Frequent use of analgesics (i.e., more than 4 times a week) can cause rebound headaches and may interfere with prophylactic treatment. Acetaminophen is sometimes combined with other drugs to form an analgesic compound (e.g., Midrin®, Fioricet®).

Side effects caused by aspirin and ibuprofen (e.g., Advil®, Motrin®) include gastrointestinal upset and bleeding. These drugs should be taken with food and used with caution. Ibuprofen is available in suppository form, which can be useful if the migraine is accompanied by severe nausea and vomiting.

Serotonin receptors (e.g., Imitrex®, Amerge®, Axert®, Zomig®), are fast-acting, usually well- tolerated medications commonly used to treat migraines. They are available in oral, injectable, and nasal spray forms and can be taken any time during the headache.

Side effects include dizziness, drowsiness, flushing, discomfort, tingling, and nausea.

Ergots (e.g., Cafergot®, Mioranal®) may be administered orally, intranasally, or as a suppository and is often combined with antinausea drugs, such as prochlorperazine (Compazine®). This medication should be taken at the first sign of a migraine and may not be effective if the headache has moved into the throbbing stage.

Side effects include gastrointestinal upset, dizziness, stroke, and high blood pressure (hypertension). Ergots should not be taken by patients with heart, vascular, liver, or kidney disease.

Migraine Headaches, Abortive Treatment reprinted with permission from neurologychannel.com
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