Migraine Medications: All You Need to Know About!

By Dr. Pallavi Sharma

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Migraine is a neurological disease characterized by recurrent headaches, sensitivity to light and sound, nausea, vomiting, and other symptoms.

It has been known for centuries that there is a strong genetic predisposition to migraine. The causes of migraines are still being researched.

Migraine headaches are often described as “debilitating” with symptoms such as throbbing pain around the head and neck, nausea, sensitivity to light, and vision changes.

These are followed by a feeling of total exhaustion. Migraine can be treated and prevented with medications. So before going deep into migraine medication, let’s see what a migraine is.

What is a Migraine?

The word “migraine” is derived from the Greek word “hemicrania,” a term used for one-sided headaches.

Migraine epidemiology studies are conducted in order to find out how many people suffer from migraine headaches worldwide.

According to statistics,

  • The worldwide prevalence of migraine is 10%.
  • It is common among the age group of 20–50 years.
  • Migraine incidence is more common among females (17%) than males (17%).

Migraine is a common disorder that affects brain signals. It can be triggered by various factors such as stress, hunger, hormonal changes, and too much caffeine or alcohol consumption.

Migraine attacks can last from hours to days, and they can be accompanied by symptoms such as nausea, vomiting, sensitivity to light and sound, dizziness, or vertigo.

However, research has shown that eating certain foods can trigger migraines in some people.

Some researchers have suggested that certain foods and beverages trigger migraines in some individuals by irritating the lining of the arteries around the brain. This is called vasospasm.

It is also possible that migraine may be caused by an imbalance of brain chemicals such as serotonin or dopamine levels as well.

Migraine Triggers

  • Food additives: Monosodium glutamate (MSG), aspartame (NutraSweet), and artificial sweeteners.
  • Food: Caffeine, cheese, processed food, chocolate, cured meats
  • Alcohol
  • Stress
  • Sleep deprivation
  • Barometric changes
  • Skipping meals
  • Strong odors, bright or flashing lights
  • Medications: hormonal birth control pills
  • Hormonal changes

By keeping a migraine diary, it will help to identify the triggers of migraine.

Acute Treatment of Migraine

This disorder is characterized by recurrent attacks of headaches and neurological symptoms, often accompanied by nausea, vomiting, and extreme sensitivity to light or sound.

The acute treatment of migraine requires the identification and elimination of the underlying cause. The cause here is the triggering factor.

A combination of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, with either acetaminophen or aspirin, is often used to treat migraine pain.

Over-The-Counter Pain Reliever Drugs

  • Acetaminophen (Tylenol)
  • Aspirin
  • Ibuprofen (Advil, Motrin)
  • Excedrin (a combination of medications; aspirin 200mg, acetaminophen 250mg, and caffeine 65mg)
  • Naproxen (Aleve)

It is unnecessary to take these painkillers every day as preventatives or in fear of migraines.

Because the prolonged use of this medication might cause rebound headaches once the drug levels are reduced in the blood.

Ergot Alkaloid

Ergotamines are a class of drugs that are used to treat migraines. They can be administered in various ways, including orally, intravenously, and rectally.

The ergotamines in migraine treatment are the most effective way to reduce the symptoms of migraine. It has been found that these medicines work by preventing the release of certain chemicals from nerve cells in the brain and spinal cord. These drugs are not indicated for cardiac patients.

  • Dihydroergotamine (D.H.E. 45, Migranal)
  • Ergotamine

Anti-Emetic Drugs

Nausea and vomiting are common symptoms of migraine. Antiemetic drugs can be bought over the counter. These are generally safe to use over the counter and the side effects are small.

  • Metoclopramide (Reglan)
  • Domperidone
  • Promethazine (Phenadoz, Phenergan)
  • Prochlorperazine (Compazine)

Triptans

Triptans are a class of drugs used to treat migraine headaches.

It works by narrowing the blood vessels around the brain, which reduces the pain and nausea associated with migraines. It also decreases inflammation in the nerves of the brain, which can reduce how often migraines occur.

It can be taken as an injection or given as a nasal spray or tablet. The injection should not be given to people who are allergic to any of its ingredients, and it should not be taken by people who have certain conditions like heart disease or uncontrolled high blood pressure.

  • Sumatriptan (Imitrex, Sumavel DosePro, Imitrex Statdose, Zembrace SymTouch, Alsuma)
  • Frovatriptan (Frova)
  • Zolmitriptan ( Zomig ZMT, Zomig)
  • Rizatriptan (Maxalt)
  • Eletriptan (Relpax)
  • Naratriptan (Amerge)
  • Almotriptan (Axert)

Migraine: Preventive Medications

Migraine is a chronic condition with episodic exacerbations (attacks). The attacks can last from four hours to three days in adults.

The frequency of attacks varies greatly among people with migraines. Some people experience migraines only once every few months, while others might experience them several times per week.

Calcitonin gene-related peptide (CGRP) antagonists

  • Rimegepant (Nurtect ODT)
  • Galcanezumab-gnlm (Emgality)
  • Ubrogepant (Ubrelvy)
  • Eptinezumab-jjmr (Vyepti)

Calcitonin gene-related peptide (CGRP) antagonists are a class of drugs that have been approved for the treatment of migraine.

The CGRP antagonists work by inhibiting the release of calcitonin gene-related peptide (CGRP), which is a neurotransmitter that is released in migraines.

This inhibits the activity of sensory neurons, reducing pain and inflammation.

Beta Blockers

These drugs act by constricting the blood vessels and reducing anxiety levels by reducing the heart rate.

  • Propranolol (Inderal)
  • Atenolol (Tenormin)
  • Metoprolol tartrate (Lopressor)
  • Timolol (Timoptic-xe, Istalol, Timoptic)
  • Nadolol (Corgard)
  • Bisoprolol (Monocor, Zebeta)
  • Calcium Channel Blocker
  • This drug is a vasoconstrictor and prevents migraine attacks.
  • Verapamil
  • Ditiazem
  • Anticonvulsants
  • Topiramate (Topamax)
  • Piramate (Depakote)
  • Gabapentin
  • Sodium valproate (Dyzantil)

Anticonvulsants are used as a preventer of migraine. They stabilize neuronal transmissions in the brain.

  • Antidepressants
  • Fluoxetine (Prozac)
  • Amitriptyline (Elavil)

Antidepressants also stabilize brain signals and will help to prevent migraine attacks.

Botox

Botox works by blocking nerve impulses, which reduces the pain signals sent to the brain.

Botox is a great treatment for migraines, but it’s important to know the side effects.

First, botox can cause headaches, dizziness, dry mouth, and numbness in your face. These side effects are temporary, and they usually go away within 24 hours.

For chronic migraineurs, this will be a treatment option.

If you’re suffering from migraines, don’t wait to see your doctor. Botox injections can help stop the pain and prevent a migraine from happening.

When to See the Doctor

Migraine headaches are often treated with medications such as ibuprofen or aspirin, but sometimes these drugs are not enough to relieve the pain.

Botox is an injection that works by blocking nerve signals in the brain that cause pain. It’s safe for most people to use.

When it comes to chronic migraine, your doctor will evaluate your symptoms and medical history before making any recommendations about whether botox treatment is right for you.

Sinister symptoms of a headache that might need special consideration are,

  • weakness of the body might indicate a stroke
  • Feelings of vertigo and dizziness might indicate a cardiac event.
  • A headache that comes on suddenly without any warning or aura (Thunderclap) might indicate subarachnoid hemorrhage.
  • Fever and neck stiffness might indicate meningitis.
  • Confusion
  • Mood disorders: depression, anxiety
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TeleHealthDoc articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Dr. Pallavi Sharma

Dr. Pallavi Sharma is one of Melbourne’s best, well respected cosmetic doctors and aims to provide longstanding anti-aging benefits for her clients. With over 11 years experience in Performing cosmetic procedures, Dr. Sharma has lectured medical professionals regarding cosmetic treatments and is heavily involved in providing up to date cosmetic treatments to her clients and friends.
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