Best Prophylactic Migraine Medications

Prophylactic Migraine Medications

Doctors sometimes prescribe a daily medication to reduce the duration and frequency of migraine attacks.

These medications are called prophylactic or preventive therapy. There are several classes of drugs approved for use as prophylactic migraine treatments.

Beta Blockers

No one knows how beta blockers prevent migraines, but they seem to. Beta blockers commonly used in migraine therapy include propranolol (Inderal), nadolol (Corgard), metoprolol (Lopressor, Toprol XL), atenolol (Tenormin), and timolol (Blocadren).

Tricyclic Antidepressants

Tricyclic antidepressants (TCAs) prevent migraine headaches by altering two of the neurotransmitters, nor epinephrine and serotonin, that the nerves in the brain use to communicate.

Since migraines and depression are considered comorbid conditions they are a particularly good fit for many migraineurs. TCAs that have been used in migraine therapy include amitriptyline (Elavil), imipramine (Tofranil), doxepin (Sinequan), and imipramine (Tofranil).

Side effects of TCAs include increased heart rate, blurred vision, difficulty urinating, dry mouth, constipation, and weight change.

Anticonvulsants

Antiseizure medications, also called anticonvulsants, have been used to prevent migraine headaches. Like many prophylactic migraine treatments, it is not known how they work to prevent migraines, simply that they do.

The anticonvulsants gabapentin, valproic acid, topiramate, and phenobarbital have all been used in migraine therapy.

Calcium-Channel Blockers

Calcium-channel blockers (CCBs), in addition to blocking calcium from entering the muscle cells of the heart, appear to block a serotonin uptake.

It is the latter that has caused their occasional use in preventing migraines. The CCBs used in preventing migraines are verapamil (Calan, Verelan, Isoptin), diltiazem (Cardizem, Dilacor, Tiazac), and nimodipine.

Antiserotonin Agents

The antiserotonin agents methysergide and methylergonovine can be used in migraine prophylaxis, but their potential side effects are so severe, including retroperitoneal fibrosis

(scarring of tissue around the ureters that carry urine from the kidneys to the bladder) and scarring around the lungs, that they are rarely used in this capacity.

Natural Treatments for Migraine

There is a huge controversy regarding natural treatments for migraine among migraine sufferers and scientists. Are there any natural options that work? The answer is not a simple one.

For the majority of natural remedies that are traditionally passed from one generation to another, they are thought to lack scientific proof and to only use the placebo effect as a means of providing relief to patients.

Despite the above fact natural treatments for migraine are widely spread and people seem to disregard scientific appeals.

One can understand that natural remedies exist for certain reasons:
1) The majority of them are based on natural substances that are easily available.

2) Usually the natural treatments are handled better than the prophylactic medications that a migraine sufferer often has to take everyday to prevent migraine attacks from occurring and with fewer side effects.

3) The cost of natural remedies are most of the times markedly less than the one of migraine medications, especially the modern ones.
4) They may work after all!

One of the most common natural treatments for migraine headache is apple cider vinegar. It is believed to normalize the body’s pH so that migraine can be prevented.

It is not scientifically proven to work but some people use drops of apple vinegar in their water or inhale the fumes of boiling water that contains apple vinegar.

Feverfew is natural herb that allegedly helps to prevent migraine attacks and to decrease the frequency of them. The migraines that occur are supposed to last less and have fewer and less severe accompanying symptoms such as nausea and vomiting.

Feverfew has been tested safely in research studies up to 3-4 months. No scientific proof exists for a period of use longer than that.

Apart from those two natural treatments for migraine there are some organized methods where a combination of strategies is used to treat migraines.

Whatever you do, before taking any supplement consult your physician as some substances can interact with your current medication or medical conditions you might have.

Migraine Abortive Medications

Doctors prescribe two types of migraine medications. One type is designed to help stop a migraine that has already begun.

This is called abortive therapy and these drugs work best when taken as soon as the headache begins. The other type is a daily medication designed to reduce the frequency of migraine attacks. This type of medication is called prophylactic or preventive therapy.

There are two common classes of migraine abortive prescriptions, triptans and ergots.

Triptans (sumatriptan, zolmitriptan, naratriptan, et al.) work by attaching to serotonin receptors on the blood vessels and nerves in the brain.

By blocking these receptors, inflammation is reduced and the vessels are able to constrict. This effectively ends the migraine for many.

Triptans are available as injections, tablets, and nasal sprays. When used early enough triptans can abort up to 80% of migraine headaches within two hours of taking the medication.

Common triptan side effects are facial flushing, tightness in the chest and/or throat, and skin tingling. Less common, though still not considered serious, are dizziness, drowsiness, and fatigue.

The biggest danger of triptans is heart attack or stroke in people with previously undiagnosed heart disease or risk factors like obesity and high blood pressure.

Ergots (ergotamine or dihydroergotamine preparations), like triptans, abort migraines by constricting of blood vessels.

Ergots are not as targeted as triptans, however, and cause constriction of vessels throughout the body, not just in the brain.

They are not considered to be as safe as triptans and are generally only recommended for patients who are unable to find relief with safer alternatives.

Ergots cause prolonged contraction of the uterus and can cause a pregnant woman to miscarry. Ergots are also much more likely than triptans to cause nausea and vomiting. Ergot brand names include Cafergot, Wigraine, Migranal, and Ergomar.

Neurostimulator Implants and Migraines

One out of every eight people suffers from migraine headaches. There is currently no treatment available to eliminate the condition; doctors merely help patients manage the symptoms.

A new treatment is being tested that may offer more pain relief than any other method to date for migraine sufferers.

In September 2006, reports began surfacing about a surgical procedure that may help migraineurs. Dr. Sandeep Amin, an anesthesiologist at Rush University Medical Centre in Chicago, Illinois, is pioneering a radical new treatment.

Dr. Amin is studying the potential of a treatment he calls “occipital nerve stimulation”. The treatment calls for the implantation of a small neurostimulator in the neck. This device sends electrical impulses to nerves under the skin at the base of the head at the back of the neck.

The device being used Dr. Amin’s nationwide, double-blind study is the Boston Scientific Precision neurostimulator. The Precision neurostimulator is the smallest rechargeable, implantable neurostimulator on the market (as of 2006) and is already FDA-approved for spinal stimulation for chronic pain treatment.

If the study is successful, it offers new hope to migraineurs, particularly those who have found their pain resistant to currently available treatment modalities.

Dr. Amin’s study is not the first. In 2004, Medtronic, Inc., a medical technology company, conducted a study of occipital nerve stimulation for migraines using one of their own devices.

The study was initiated after a Dallas doctor successfully used the experimental treatment to relieve pain for a migraineur.

A review of the company’s website, www.medtronic.com, showed no information on the study, making it likely that, for whatever reason, the 2004 study was unsuccessful.

Dr. Amin states that his treatment is not for everyone, and, if it is successful, recommends it only for patients who have been unable to achieve pain relief through medication or other, more common, treatment methods.

Natural Treatments for Migraine

There is a huge controversy regarding natural treatments for migraine among migraine sufferers and scientists. Are there any natural options that work? The answer is not a simple one.

For the majority of natural remedies that are traditionally passed from one generation to another, they are thought to lack scientific proof and to only use the placebo effect as a means of providing relief to patients.

Despite the above fact natural treatments for migraine are widely spread and people seem to disregard scientific appeals.

One can understand that natural remedies exist for certain reasons:-
1) The majority of them are based on natural substances that are easily available.

2) Usually the natural treatments are handled better than the prophylactic medications that a migraine sufferer often has to take everyday to prevent migraine attacks from occurring and with fewer side effects.

3) The cost of natural remedies are most of the times markedly less than the one of migraine medications, especially the modern ones.

4) They may work after all!

One of the most common natural treatments for migraine headache is apple cider vinegar. It is believed to normalize the body’s pH so that migraine can be prevented.

It is not scientifically proven to work but some people use drops of apple vinegar in their water or inhale the fumes of boiling water that contains apple vinegar.

Feverfew is natural herb that allegedly helps to prevent migraine attacks and to decrease the frequency of them. The migraines that occur are supposed to last less and have fewer and less severe accompanying symptoms such as nausea and vomiting.

Feverfew has been tested safely in research studies up to 3-4 months. No scientific proof exists for a period of use longer than that.

Apart from those two natural treatments for migraine there are some organized methods where a combination of strategies is used to treat migraines.

Whatever you do, before taking any supplement consult your physician as some substances can interact with your current medication or medical conditions you might have.

Transformed Migraine

Migraine headaches bring some of the most excruciating pain a person will ever know. Many migraineurs say the only good thing about a migraine is the relief, sometimes even euphoria, they feel when the headache is over.

Knowing that a good feeling is waiting on the other side is the only thing that helps some of them get through the pain.

People who live with transformed migraine (TM) do not have anything to look forward to. Transformed migraine is the name of a condition some migraineurs develop after years of migraine episodes. Most people develop transformed migraines in their 20s or 30s.

Migraineurs report less severe headaches suddenly, but they come more often until they turn into chronic daily headaches (CDH).

The daily headache is less intense than a migraine episode, but still painful, and most transformed migraine patients still have occasional full-blown migraine episodes.

Not all migraineurs will develop transformed migraines. In fact, most won’t. Those who do are predominantly women and approximately 90% of them previously had migraine with aura (classic migraine).

Migraine with aura is relatively rare, affecting less than 20% of all migraineurs.

The exact cause of transformed migraines is, like all migraine types, unknown.

Many transformed migraineurs are heavy users of pain-relievers, both over the counter items like acetaminophen and naproxen and prescription medications like Vicodin or Darvon.

Some even take them daily, whether they have a migraine or not, thinking they may help prophylactically.

TM patients of this type are particularly hard to treat because of a developed tolerance for pain medication. The first step in treating these patients is to wean them from their daily medications. Sometimes this step alone will stop the chronic lesser headaches.

Once weaned, like non-medication dependent TM patients, their migraines are manageable with a regular treatment regimen just like any other migraineur.

Helpful Tips Offering Relief From Migraine Headaches

Migraine headaches affect millions of individuals around the world. They are extremely painful and hard to bear.

Migraines can last anywhere from one hour to three or four days. Within that time, it may literally be impossible for migraine suffers to function properly.

Although relief might not come right away, there are many options available that soothe or cure migraine headaches.

A migraine is classified as a serve headache that can often impair one’s judgment. When a migraine occurs, suffers regularly experience the following symptoms:

• Headache
• Dizziness
• Nausea
• difficulty seeing

It is not uncommon for migrane suffers to be unable to look at lights or the sun without suffering intense pain. Migrane headache may be brought on by a variety of things.

Children and adults are susceptible to migraines, and they often happen unexpectedly. Migraines can be brought on by stress, certain foods, a poor eating habits, or hormones.

Migraine headaches are also hereditary, therefore, there are many families may experience migraine headaches at the same time.

The best way to get relief from migraine headaches is by speaking to your physician. If you suspect that you are suffering from migraines, you most likely are, however, many treatment options must first be prescribed by a healthcare professional.

There are physicians who specialize in migraines and other head related pains, however, your family physician can often diagnose and offer treatment options for receiving relief from migraine headaches.

Over the counter pain killers are the best available option for getting quick relief from migraine headaches without visiting a physician.

Aspirin, ibuprofen, and acetaminophen are common over-the-counter drug medications that are available at most drug or department stores,and they can normally be purchased at a fairly low price.

If you regularly suffer from migraine headaches, it may be a good idea to have some of this medication on hand. There are even over the counter medications designed specifically for relief from migraine headaches.

It is important to remember that an excessive dosage of these over-the-counter drugs can cause liver or stomach damage. They relieve, but do not cure, your migraine headaches, nor do they preven them from returning.

Over-the-counter medications offer temporary relief for your migraine headaches, often until you have been properly examined and treated by a physician.

One of the easiest ways to receive relief from migraine headaches is by sleeping. Although it will not eliminate your pain, rest and relaxation is an effective way to help minimize or reduce the excruciating pain of migraine headaches.

If you are able to take a break, laying down or just resting inside a dark, quiet room may allow you to order your thoughts and to reduce your stress levels. Sleeping or resting may offer much needed pain relief from migraine headaches.

If you are unable to control the pain associated with your migraine headaches, it is extremely important that you contact your physician.

Beta blockers, along with other medications, offer quick relief from migraine headaches, however, they are only available with a prescription.

If you experience migraines, do not suffer any longer than you need to. Contact your physician or healthcare professional for effective ways to receive relief from your migraine headaches.

Confusing Retinal Migraine

Due to the varied types of the disease, most doctors would diagnose migraine based on the universally accepted standards of The International Classification of Headache Disorders (ICHD) to avoid misdiagnosis.

Retinal migraine is a classic example of confusion and misdiagnosis, simply because the term is often poorly understood and widely misused.

When a migraine sufferer is given a diagnosis that lacks accuracy in diagnostic terms but is given more of a descriptive term, a problem may arise.

When these descriptive terms are used frequently, they miss out on its real diagnosis. The International Headache Society (IHS) came up with a standard diagnosis to make communications easier for patients who need to consult other doctors or change doctors.

Retinal Migraine is an actual migraine diagnosis which is often misused to define any migraine that is associated with any visual symptoms, or a migraine with visual symptoms minus the headache.

It is characterized by recurrent attacks of unilateral visual disturbances that precedes the headache period of the migraine attacks, starting with monocular (affecting one eye) visual symptoms such as scintillations, scotoma, and temporary loss of vision.

Symptoms
Scintillation is the perception of lights flashing in different intensity during the migraine aura and can be a symptom of the aura phase of a migraine attack.

The headache period begins during or within sixty minutes of the visual symptoms that are consistent with migraine without aura: Headache duration of 4 to 72 hours.

Symptoms should have at least two of the following characteristics:
1. unilateral location
2. pulsatile quality
3. moderate or severe pain intensity

4. aggravation by or causing avoidance of routine physical activity such as walking or climbing stairs
And at least one of these characteristics:
1. nausea and/or vomiting

2. photophobia (heightened sensitivity to light) and phonophobia (heightened sensitivity to sound)
The main difference between retinal migraine and migraine with aura

(neurological phenomenon) is that the former has monocular visual symptoms as well as total, but temporary, monocular blindness.

Since there are no known causes of migraine disease, diagnosis is done by tracing the personal and family medical history of the patient to rule out other causes of the symptoms.

Treatment and Remedies
There are several over-the-counter and prescription medicines that can provide migraine remedies or aid in relieving symptoms of attacks when they happen. For most people, treatments to relieve stress prove to be equally helpful as migraine remedies.

Retinal migraine is a diagnosis of exclusion, however, and patients will generally require a complete cardiovascular evaluation to rule-out embolic and other vascular disease as a cause of the visual loss.

Patients diagnosed with this condition may be treated in the same fashion as patients with migraine.
Patients who are having infrequent episodes are given medications used for other forms of migraine to relieve other symptoms.

These medications can include nonsteroidal anti-inflammatory drugs (NSAIDs), anti-nausea medications among others.

The choice of medications may depend on the age of the patient’s severity of the condition. For frequent migraine attacks, the same preventive therapies used for other migraines can be explored.

But, as always, remember to consult your physicians for proper diagnosis of your condition before taking any medication.

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