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To Your Health
Straight Talk From Rye Beach Pharmacy: Migraines
– By Steven Dershowitz R.Ph., Lead Pharmacist –
What is a Migraine?
Just about everyone has headaches. A migraine is different. Sufferers describe it as a severe, recurring headache with an intense throbbing pain on one side of the head (although a third of the attacks can affect both sides). A migraine can last from four hours to three days, and is often, but not always, accompanied by visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound and light, and tingling or numbness in the extremities or face. In 15-20% of cases, neurological symptoms occur in advance of the actual headache. These symptoms, which last 20-60 minutes, are referred to as the aura phase of the headache.
Women and Migraine
Approximately 22 million women are affected by migraines in the United States, three times as many as men. After adolescence, when estrogen influence begins in young girls, the risk of a migraine and its severity rises in females. Estrogen adversely influences the brain receptors that play a role in migraine development. About half of affected women have more than one attack each month.
Children and Migraine
Half of all migraine sufferers have their first attack before the age of 12. One out of ten school-age children suffer from migraines, some as young as 18 months old. The illness often goes undiagnosed in children, because unexplained nausea or vomiting, abdominal pain, or severe vertigo may occur with only minor or even no head pain. Motion sickness is an early warning of the predisposition to childhood migraines.
Treatment
In the past, doctors often diagnosed patients with disabling head pain as neurotic and dismissed their complaints as psychiatric in nature. Later, researchers believed that the dilation and constriction of blood vessels in the head were the primary source of the pain; early migraine medications targeted the blood vessels for treatment. Researchers now believe that a migraine involves nerve pathway and brain chemicals. There is also evidence that links a number of genes to migraines.
There are three principal approaches to treating migraines. Acute treatment uses drugs to relieve the symptoms of attacks when they occur. Preventive treatment uses drugs taken daily to reduce the number of attacks and lessen the intensity of pain. Complementary treatment, which does not use drugs, includes biofeedback, relaxation techniques, exercise, and proper rest and diet, all of which may help avoid the triggering or provocation of attacks.
Choosing from the 100+ drugs used to prevent or treat migraine symptoms is time-consuming and frequently requires expert help from doctors or centers specializing in the treatment of migraine.
Common Triggers
Migraine “triggers” don’t cause migraines, but they may set the processes in motion that bring on migraines in people who are already prone to them. A trigger may not induce a migraine every time, and one person’s triggers may not affect another. That’s why it’s a good idea to keep a Migraine Diary. You can discuss your diary with your health professional with the goal of identifying and avoiding triggers that may affect you. Some of the more common Migraine triggers include:
Lifestyle/Environmental
Skipping meals or fasting
Changes in sleep patterns
Weather changes
Bright or flickering lights
Odors and pollution
Stress
Overexertion
Menstruation
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Foods
Chocolate
Processed meats
Aged cheese
Alcohol or red wine
Too much caffeine
Monosodium glutamate (MSG)
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Migraine Drug Information
Midrin (Epidrin)
This combination medication is used to relieve tension and migraine headaches. Acetaminophen helps to decrease the pain from the headache, Isometheptene narrows the widened blood vessels in the head and Dichloralphenazone relaxes the body.
Maxalt (Rizatriptan)
Rizatriptan helps relieve headache pain and other symptoms of migraines, including sensitivity to light/sound, nausea, and vomiting. Rizatriptan does not prevent future migraines or reduce how often you get headache.
Amerge Oral (Naratriptan)
This medication helps to relieve headaches, pain and other symptoms of migraines, including sensitivity to light/sound, nausea, and vomiting. Prompt treatment allows you to get back to your normal routine and may decrease your need for other pain medications. Naratriptan does not prevent future migraines or reduce how often you may get them.
Frova Oral (Forvatriptan)
See Naratriptan.
Topamax (Topiramate)
Topiramate is used to prevent migraine headaches and reduce their frequency. Topiramate does not treat a migraine headache once it occurs.
Fioricet Oral
This combination medication is used to treat tension headaches. Acetaminophen helps to decrease the pain from the headache. Caffeine helps increase the effects of acetaminophen. Butalbital is a sedative that helps to decrease anxiety and cause sleepiness and relaxation.
Imitrex
Imitrex treats migraine headaches that have already begun by narrowing the blood vessels around the brain. It also reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms. Imitrex tablets and nasal spray are used to treat migraine headaches. It will not prevent headaches or reduce the number of attacks.
Natural Products
Menthol Cone
Menthol Cone is applied to the forehead and will relieve a migraine headache by 50-100% within 120 seconds.
Migrelief
Migrelief either alone or in combination with petadolex will prevent migraines.
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