Migraine

 

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Intense throbbing and/or a pulsing sensation in an area of the head are typically associated with migraine headache. Generally migraines are accompanied by vomiting, nausea and elevated sensitivity to light and sound. The random attacks by migraine causes much pain for hours or days and sometimes so severe it makes you want to find a dark quiet place to lie down. Some migraine symptoms are also accompanied by
flashes of light, blind spots and tingling sensation in your arm or leg.

Medication can be taking to help reduce the irritation caused by migraines. Certain treatment might not be as effective as others, make sure you consult with a doctor to help find the best one for you. With appropriate medicines and lifestyle changes, it may make a huge difference.

Migraines can’t be cured, but doctors will work with you to help you manage your condition.

Treatments

A variety of medications have been specifically designed to treat migraines. Medications used to combat migraines fall into two broad categories:

Pain-relieving medications. These types of drugs are taken during migraine attacks and are designed to stop symptoms that have already begun.

Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Some medications aren’t recommended if you’re pregnant or breast-feeding. Some medications aren’t given to children.
Your doctor can help find the right medication for you.

For the most effective results, take pain-relieving drugs as soon as you experience signs or symptoms of a migraine. It may help if you rest or sleep in a dark room after taking them. Medications include:

Pain relievers. Aspirin, or non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others), may help relieve mild migraines. Pain relievers, such as acetaminophen (Tylenol, others), also may help relieve mild migraines in some people.
Drugs marketed specifically for migraines, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraine pain, but aren’t effective alone for severe migraines.
Triptans. Many people with migraine attacks use triptans to treat their migraines. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain. Triptans effectively relieve the pain and other symptoms that are associated with migraines.
Medications include sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax). Some triptans are available as nasal sprays and injections, in addition to tablets.
A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own.

Anti-nausea medications, Opioid medications. Glucocorticoids (prednisone, dexamethasone) and others.

SUMMARY

There is high-quality evidence from placebo-controlled randomized trials that the following drugs are effective for the treatment of acute migraine attacks:

Nonsteroidal anti-inflammatory drugs (NSAIDs): Aspirin, Ibuprofen, Diclofenac, Naproxen etc.

Triptans: Sumatriptan, Rizatriptan, Eletriptan, Almotriptan, Zolmitriptan, Naratriptan, Frovatriptan etc.

The combination of sumatriptan and naproxen.

Antiemetic/dopamine receptor antagonists: Chlorpromazine, Prochlorperazine and Metoclopramide.

For adults with mild to moderate migraine attacks not associated with vomiting or severe nausea, we suggest initial treatment with simple analgesics, including NSAIDs or tylenol, rather than other migraine-specific agents.

For adult outpatients with moderate to severe migraine attacks, we suggest treatment with a triptan or the combination of sumatriptan-naproxen, rather than other migraine-specific agents. There are no efficacy data that definitively support use of one triptan versus another; different pharmacologic properties and delivery routes may help guide the choice. Patients who do not respond well to one triptan may respond to a different triptan.

Abortive treatments for migraine are usually more effective if they are given early in the course of the headache; a large single dose tends to work better than repetitive small doses. Triptan treatment, in particular, should be given at the first sign of pain in patients susceptible to cutaneous allodynia.

Many oral agents are ineffective in migraine because of poor absorption secondary to migraine-induced gastric stasis. Therefore, a non-oral route of administration should be selected for patients whose migraines present early with significant nausea or vomiting.

Above guide lines are for information only, not a treatment plan by Dr.Paul Kattupalli. Every individual is different. You can meet him for a personalized treatment plan. Our phone is 814 424 2095.

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