Medical Health Encyclopedia

PREVENTING MIGRAINES

Many medications can reduce the frequency of migraines. Generally, these need to be taken daily in order to be effective. These medications are less useful and tolerable to patients with infrequent headaches. Medications in this category include:

• Beta-blockers (e.g., propanolol)
• Anti-depressants (e.g., amitriptyline)
• Anti-convulsants (e.g., valproic acid)
• Calcium-channel blockers (e.g., verapamil)
• Serotonin re-uptake inhibitors

STOPPING AN ATTACK

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Other medications are taken when there is the first sign of an impending migraine attack. In the case of migraine with aura, this is typically when the visual disturbances are first noted. These medications can effectively stop the migraine in its tracks, preventing the progression to other migraine symptoms or reducing the severity of the attack.

Many of these medications cause constriction of blood vessels and cannot be given to patients at risk of heart attack or other conditions. These medications include:

• Ergots (e.g., DHE-45)
• Serotonin agonists / triptans (e.g., sumatriptan)
• Isometheptene

These medications come in various preparations to enable administration via different routes. For example, patients who experience vomiting and cannot keep pills down may benefit from a nasal spray or injectable dose.

Call for an appointment with your health care provider if taking an ergotamine-containing medication and you are likely to become pregnant (these medications can have serious side effects to a developing fetus).

TREATING SYMPTOMS

Other medications are primarily given to treat the symptoms of migraine. Used alone or in combinations, these drugs can minimize pain, nausea, or emotional distress caused by the migraine. Some of these medications may also have some effect on the underlying process in addition to providing symptomatic relief. Medications in this category include:

• Anti-emetics (e.g., prochlorperazine)
• Sedatives (e.g., butalbital)
• Anti-inflammatories (e.g., ibuprofen)
• Acetaminophen
• Narcotic analgesics (e.g., meperidine)