Best medications and treatments to counter Migraine Headache attacks

What causes Migraine headaches and how to effectively treat them.

Migraine head pain is one of the most prevalent headaches that is least understood by the medical community. Nearly 13% of the world's population experience this excruciating and throbbing pain at some point in their lives. Symptoms of this head pain vary a lot in different patients so much that it becomes challenging to diagnose and treat it.

Migraine pain can hamper the everyday activities of patients. Patients' productivity is greatly reduced since under pain they could not perform their work with ease. Their relationships become stressed due to broken commitments they make before a pain attack. It becomes nearly impossible to concentrate and plan your activities when you experience migraine headaches. Patients describe migraine headache as throbbing pain erupting deep from the head itself on one side of the head only. Lasting from several hours to days, migraines may cause sensitivity to sound and light and can even cause vomiting and nausea.

One among five migraine patients reports vision disturbances called Aura, just before the start of a Migraine. These auras can be reported as blind spots, flashing lights or stars, or zigzag lines.

Women are more prone to Migraine head attacks than men. The men-women ratio when talking about migraine pain is 1: 3. Migraine headaches that are running in families are linked to certain nervous system disorders that may have occurred post-trauma.

Causes of Migraine

While there is no definite universally accepted answer for the cause of migraine but certain theories have been manipulated over the years that could answer the cause of Migraine which are as follows:

Excruciating pain radiating from the brain sensory neurons.

A distorted nervous system stems from the brain.

Low level of the happiness-inducing chemical serotonin in the brain.

Emotional issues that trigger brain receptors

Vitamin B or other mineral deficiency.

Some patients have negative allergic reactions to different foods like wheat/gluten, milk sugar, Yeast, corn, citrus fruits, eggs, aspartame which can trigger migraine to some extent.

Some patients are reactive to certain medicines.

Lack of sleep or Insomnia

Genetically Inherited: research shows that 70-90% of migraine patients have a family history of migraine headaches.

Environmental triggers: Obnoxious smells can sometimes start a migraine attack.

Diagnosis Of Migraine

If you have a family history of migraine or you are experiencing half-sided brain pain then the expert neurologist is the one who can help you. He will diagnose your migraines through different parameters like symptoms, neurological examination, etc. If your condition becomes severe then certain tests are carried out to determine whether such condition is due to migraine.

A diagnostic test to examine Migraine

Magnetic Resonance Imaging or MRI scan is powerful magnetic field-induced radio waves that produce detailed images of the brain and blood capillaries. MRI scans assist doctors to diagnose tumors, strokes, bleeding in the brain, infections in the brain to examine brain or nervous system health.

Computer Tomography

Computerized Tomography or CT scan uses a series of X-rays to create detailed cross-sectional images of the brain. This assists doctors to diagnose tumors, infections, brain damage bleeding in the brain, and other possible medical issues that may be causing Headaches.

Lumbar puncture or Spino fluid study (Spinal Tap)

Migraine Treatment

Some patients instantly go for over-the-counter pain killers such as Ibuprofen or acetaminophen but these medications may stop the pain radiation for some hours only. Mainstream doctors prescribe triptans that decrease inflammation and regulate blood flow in the brain. Pain killers may relieve pain for some time but don’t address the root cause therefore migraine returns. Painkillers can even cause brain fog, other unpleasant side effects or can trigger rebound headaches that are equally painful as Migraine.

To effectively treat migraine headaches, the root cause has to be found. Chiropractors focus on getting to the base of what is producing the headache. There are no one-size-fits-all solutions, chiropractic care focuses on the unique characteristics of migraine.

Chiropractic treatments involve moving, stretching, and exerting gentle pressure on the spine to let the body heal itself naturally. You will experience instant pain relief at your chiropractic appointment, followed by reduced migraine frequency as the treatment passes through a few appointments. There might be suggestions for your lifestyle changes such as drinking more water, getting more rest, taking hot or cold baths, and extending your sleeping hours. Certain exercises could be recommended to release tension and discomfort in your neck and spine.

Migraine-struck people can be treated with two preventives medications.

Pain-relieving medications- Also known as a critical treatment, these drugs are taken during migraine attacks and are taken to stop symptoms.

Pain Relieving Medications- These medications are taken regularly to reduce the severity and frequency of migraines.

Treatment choice depends on the severity of your headache, whether do have nausea or vomiting with the headache, how severe the headache is, about other medical treatments.

Medication to cope with Migraine headache

The medication used to reduce migraine pain work when the first sign of oncoming migraine starts, the medications used are-

Pain Relievers- These prescription-based medications used to treat migraine include aspirin or ibuprofen (Advil, Motrin IB, etc.) soon when symptoms of migraine start. When consumed for a long duration these drugs can cause ulcers and bleeding in the gastrointestinal tract.

Migraine relief medications can be a combination of caffeine, aspirin, and acetaminophen that work to relieve mild migraine pain.

Triptans- Drugs like Sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt- MLT) are used to treat migraine by blocking pain pathways in the brain. Taken as small pills, shots, or nasal sprays, they can soothe migraine ache, yet they are not safe for those who are at risk of a stroke or heart attack.

Dihydroergotamine (D.H.E 45, Migranal) is available in the form of spray or injectables, this is the most effective drug to counter migraine when symptoms start that could last for more than 24 hours of relief. The side effects include vomiting and nausea. People with coronary artery disease, High blood pressure, or kidney or liver disease should avoid taking Dihydroergotamine.

Lasimiditan( Review)- this is a newly approved oral tabled used to treat migraine. Lasmiditan reduces headache to an extent but it may have sedative effects that may cause dizziness, therefore patients under the influence of this drug are recommended not to drive or operate machines for about eight hours.

Ubrogepant This oral calcitonin gene-linked peptide receptor is approved for severe migraine with aura to relieve pain. In drug trials, it is more effective than a placebo and covers symptoms such as nausea or sensitivity to light and sound just two hours after taking it. Side effects of this drug include dry mouth, nausea, or vomiting with insomnia.

Opioids- Those patients who are ineffective with the above drug treatments might be going for opioid drugs to treat migraine headaches but these are usually addictive and prescribed when other treatments do not work.

Prophylactic treatments of Migraine to counter side effects

Anti-Nausea drugs- These are recommended to treat nausea and dizziness in patients with migraine drugs including Chlorpromazine, Metoclopramide, or Prochlorperazine. These are taken with pain relievers. Certain medications are avoided during pregnancy.

Blood Pressure lowering Medications- These include beta-blockers such as propranolol and Metoprolol tartrate. Calcium channel blockers such as verapamil prevent migraines with aura.

Antidepressants- Tricyclic antidepressant Amitriptyline prevents migraine.

Anti Epileptic drugs- Valproate and topiramate help in less frequent migraines, but come with side effects like dizziness, weight gain, nausea, and more. Not recommended for pregnant women.

Home remedies to treat Migraine

With the onset of a migraine head to a quiet dark room, close your eyes, rest or take a nap for some time. Place an ice pack towel on your forehead and drink a lot of water to remain hydrated.

Relaxation techniques- Biofeedback exercises reduce muscle tension by monitoring and controlling certain physical responses related to stress

Proper sleeping hours should be maintained to ease nerves and the brain thereby releasing tensions and strain among muscles and blood vessels.

Keep track of Headache: Recording symptoms of headache in dairy assist to maintain the duration of a migraine attack, the severity of the attack and what remedies and medications help you most, and what primary aid must be taken.

Exercise Regularly. Aerobic exercises reduce tension and help prevent migraine. Routine exercises like walking, swimming, and cycling will lead to a reversal of headache symptoms that occur frequently. Exercises also maintain your body weight.

Meditation and yoga. Meditate and do yoga to reduce the severity of migraine, if done regularly yoga will reduce the frequency and duration of migraine.

Herbs, Vitamins, and minerals- Doses of vitamin B-2 reduce the frequency and severity of migraine headaches. Coenzyme Q10 supplement decrease the frequency of migraine suggests a study. Magnesium supplements decrease the frequency of Migraine but further studies are needed for proven results.

References

https://blackdoctor.org/best-migraine-treatments/

Top 8 migraine treatment guidelines in 2022 - Tuhoangkaido

Diagnosis and management of migraine in ten steps - PMC (nih.gov)