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A migraine is a type of headache that is accompanied by symptoms such as nausea, vomiting, or light or sound sensitivity. Many people who experience migraines have throbbing pain on one side of the head. Experts believe migraines are a result of abnormal brain activity involving the nerves and chemicals in the nervous system as well as changes in blood flow. There is also a genetic component to migraines because they tend to run in families. Migraines occur most often between the ages of 18 and 45 and are two to three times more common in women than men.
Common Migraine Triggers
Migraines can be triggered by certain foods like dairy; chocolate; tyramine-containing foods (cheese, red wine); foods with MSG or monosodium glutamate (a flavor enhancer commonly used in canned and processed food as well as Chinese food); certain meats like hot dogs, salami, bacon, and cured meats; nuts and seeds; processed, fermented, marinated, or pickled foods; fruits like bananas, avocados, and citrus fruits; and onions.
Other things that can trigger migraine attacks include hormonal changes (for example, during a woman’s menstrual cycle), lack of sleep, caffeine withdrawal, alcohol, strenuous exercise, mental stress or anxiety, strong odors or perfumes, missed meals, loud noises, bright lights, and exposure to smoke.
Medications for Migraine
There is a huge variety of medications available for migraine treatment. Since there is no standard treatment for migraines, the choice of medications is made on an individual basis. Broadly speaking, migraine medications are divided into two categories.
Acute medications are taken for symptom control when the migraine starts.
- Analgesics (pain relievers) like aspirin, diclofenac, ibuprofen, naproxen, and paracetamol can be used to treat migraine pain. Several combinations are available, such as an analgesic plus caffeine or antiemetic (medication for nausea and vomiting).
- Antiemetics (anti-nausea medications) like domperidone, prochlorperazine, and metoclopramide help control associated symptoms like nausea and vomiting during a migraine attack.
- Triptans like almotriptan, eletriptan, frovatriptan, naratriptan, riztriptan, sumatriptan, and zolmitriptan are FDA-approved first-line medications for acute migraine episodes. They work by causing vasoconstriction (narrowing of blood vessels) in the brain.
Prophylactic medications are taken to prevent migraine attacks.
- ACE inhibitors and angiotensin receptor blockers (ARBs) like candesartan and lisinopril.
- Anticonvulsants like topiramate and sodium valproate.
- Beta blockers like atenolol, propranolol, metoprolol, timolol, and nadolol.
- Calcium channel blockers like flunarizine.
- CGRP monoclonal antibodies like erenumab, galcanezumab, and fremanezumab.
- Tricyclic antidepressants like amitriptyline.
The mode of action of these medications in preventing migraines varies and is not always well understood. Beta-blockers, ACE inhibitors, ARBs, and calcium channel blockers are antihypertensives (medications used to treat high blood pressure) and they may work through their effect on blood vessels. Anticonvulsants are believed to reduce pain signals in the brain.
Over-the-Counter Medications for Migraines
Certain over-the-counter supplements like coenzyme Q10, riboflavin, and magnesium may help with migraine symptoms. Also, many painkillers are available over-the-counter, and for many people, these OTC medications are a safe and effective way to manage their migraines.
However, it is worth noting that frequent use of pain relievers can lead to something called medication-overuse headaches or rebound headaches. If you take painkillers frequently, the body develops a tolerance to the drugs and you need larger or more frequent doses to get relief from pain. This can lead to a situation where the medications actually make your headaches worse or more frequent. Therefore, while it is alright to use OTC pain medications for occasional migraines, if you have attacks more than once or twice a month, it is highly recommended that you seek professional medical care.
Common Side Effects of Migraine Medications
Potential side effects of analgesics include dry mouth, constipation, nausea, drowsiness, and itchy skin.
Common side effects of antiemetics include fatigue, restlessness, dizziness, confusion, headaches, sleep disturbances, and depression.
Triptans can cause side effects such as flushing, numbness, tingling, chest tightness, and neck pain. Very rarely, arrhythmias (heart rhythm abnormalities), heart attacks, and strokes can occur as adverse effects of triptans.
Possible side effects of antihypertensive drugs used for migraine treatment (ARBs, ACE inhibitors, beta-blockers, and calcium channel blockers) include cough, constipation, diarrhea, dizziness, tiredness, headache, nausea, vomiting, skin rash, weight loss, and erection problems in men.
Anticonvulsants like topiramate and sodium valproate can cause drowsiness, dizziness, fatigue, headache, nervousness, shakiness, tingling, nausea, vomiting, diarrhea, and weight loss or weight gain as side effects.
CGRP monoclonal antibodies can potentially cause cardiovascular side effects like hypertension, skin issues like redness, inflammation, and wound healing problems, gastrointestinal ulcers, and irritable bowel.
Common Questions
How can I tell if my headache is a migraine?
Migraine is a common type of headache, but not all headaches are migraines. Characteristic features of a migraine include one-sided throbbing pain that lasts for up to 72 hours and is associated with nausea, vomiting, and/or sensitivity to sound or light. There are two main types of migraines. Some migraines begin without any warning symptoms – they are called common migraines or migraines without aura. Some migraines are preceded by warning symptoms 20-30 minutes before the headache, such as flashes of light, blind spots, or other visual disturbances called an aura – these are known as classic migraines or migraines with aura.
Can you outgrow migraines?
As noted above, migraines are 2-3 times more common in women than men. In about one-third of women, migraines disappear or improve considerably after menopause. In others, the migraines change in character or continue as before. In men as well, migraines often go away after the age of 50 or 60. The reason for the improvement in migraines with age is not well understood.
Can I get a discount on migraine medications with BuzzRx?
Yes, you can get discounts on some medicines—including medications to prevent and treat migraine—as long as you have a signed prescription from your doctor.
References:
1. https://medlineplus.gov/ency/article/000709.htm
2. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912a8.htm
3. https://www.migrainetrust.org/living-with-migraine/treatments/medication/
4. https://www.arthritis.org/drug-guide/analgesics/analgesics
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798203/
6. https://www.ncbi.nlm.nih.gov/books/NBK554507/
7. https://medlineplus.gov/ency/article/007484.htm
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612904/
9. https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/headache/faqs.html#
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A migraine is a type of headache that is accompanied by symptoms such as nausea, vomiting, or light or sound sensitivity. Many people who experience migraines have throbbing pain on one side of the head. Experts believe migraines are a result of abnormal brain activity involving the nerves and chemicals in the nervous system as well as changes in blood flow. There is also a genetic component to migraines because they tend to run in families. Migraines occur most often between the ages of 18 and 45 and are two to three times more common in women than men.
Common Migraine Triggers
Migraines can be triggered by certain foods like dairy; chocolate; tyramine-containing foods (cheese, red wine); foods with MSG or monosodium glutamate (a flavor enhancer commonly used in canned and processed food as well as Chinese food); certain meats like hot dogs, salami, bacon, and cured meats; nuts and seeds; processed, fermented, marinated, or pickled foods; fruits like bananas, avocados, and citrus fruits; and onions.
Other things that can trigger migraine attacks include hormonal changes (for example, during a woman’s menstrual cycle), lack of sleep, caffeine withdrawal, alcohol, strenuous exercise, mental stress or anxiety, strong odors or perfumes, missed meals, loud noises, bright lights, and exposure to smoke.
Medications for Migraine
There is a huge variety of medications available for migraine treatment. Since there is no standard treatment for migraines, the choice of medications is made on an individual basis. Broadly speaking, migraine medications are divided into two categories.
Acute medications are taken for symptom control when the migraine starts.
- Analgesics (pain relievers) like aspirin, diclofenac, ibuprofen, naproxen, and paracetamol can be used to treat migraine pain. Several combinations are available, such as an analgesic plus caffeine or antiemetic (medication for nausea and vomiting).
- Antiemetics (anti-nausea medications) like domperidone, prochlorperazine, and metoclopramide help control associated symptoms like nausea and vomiting during a migraine attack.
- Triptans like almotriptan, eletriptan, frovatriptan, naratriptan, riztriptan, sumatriptan, and zolmitriptan are FDA-approved first-line medications for acute migraine episodes. They work by causing vasoconstriction (narrowing of blood vessels) in the brain.
Prophylactic medications are taken to prevent migraine attacks.
- ACE inhibitors and angiotensin receptor blockers (ARBs) like candesartan and lisinopril.
- Anticonvulsants like topiramate and sodium valproate.
- Beta blockers like atenolol, propranolol, metoprolol, timolol, and nadolol.
- Calcium channel blockers like flunarizine.
- CGRP monoclonal antibodies like erenumab, galcanezumab, and fremanezumab.
- Tricyclic antidepressants like amitriptyline.
The mode of action of these medications in preventing migraines varies and is not always well understood. Beta-blockers, ACE inhibitors, ARBs, and calcium channel blockers are antihypertensives (medications used to treat high blood pressure) and they may work through their effect on blood vessels. Anticonvulsants are believed to reduce pain signals in the brain.
Over-the-Counter Medications for Migraines
Certain over-the-counter supplements like coenzyme Q10, riboflavin, and magnesium may help with migraine symptoms. Also, many painkillers are available over-the-counter, and for many people, these OTC medications are a safe and effective way to manage their migraines.
However, it is worth noting that frequent use of pain relievers can lead to something called medication-overuse headaches or rebound headaches. If you take painkillers frequently, the body develops a tolerance to the drugs and you need larger or more frequent doses to get relief from pain. This can lead to a situation where the medications actually make your headaches worse or more frequent. Therefore, while it is alright to use OTC pain medications for occasional migraines, if you have attacks more than once or twice a month, it is highly recommended that you seek professional medical care.
Common Side Effects of Migraine Medications
Potential side effects of analgesics include dry mouth, constipation, nausea, drowsiness, and itchy skin.
Common side effects of antiemetics include fatigue, restlessness, dizziness, confusion, headaches, sleep disturbances, and depression.
Triptans can cause side effects such as flushing, numbness, tingling, chest tightness, and neck pain. Very rarely, arrhythmias (heart rhythm abnormalities), heart attacks, and strokes can occur as adverse effects of triptans.
Possible side effects of antihypertensive drugs used for migraine treatment (ARBs, ACE inhibitors, beta-blockers, and calcium channel blockers) include cough, constipation, diarrhea, dizziness, tiredness, headache, nausea, vomiting, skin rash, weight loss, and erection problems in men.
Anticonvulsants like topiramate and sodium valproate can cause drowsiness, dizziness, fatigue, headache, nervousness, shakiness, tingling, nausea, vomiting, diarrhea, and weight loss or weight gain as side effects.
CGRP monoclonal antibodies can potentially cause cardiovascular side effects like hypertension, skin issues like redness, inflammation, and wound healing problems, gastrointestinal ulcers, and irritable bowel.
Common Questions
How can I tell if my headache is a migraine?
Migraine is a common type of headache, but not all headaches are migraines. Characteristic features of a migraine include one-sided throbbing pain that lasts for up to 72 hours and is associated with nausea, vomiting, and/or sensitivity to sound or light. There are two main types of migraines. Some migraines begin without any warning symptoms – they are called common migraines or migraines without aura. Some migraines are preceded by warning symptoms 20-30 minutes before the headache, such as flashes of light, blind spots, or other visual disturbances called an aura – these are known as classic migraines or migraines with aura.
Can you outgrow migraines?
As noted above, migraines are 2-3 times more common in women than men. In about one-third of women, migraines disappear or improve considerably after menopause. In others, the migraines change in character or continue as before. In men as well, migraines often go away after the age of 50 or 60. The reason for the improvement in migraines with age is not well understood.
Can I get a discount on migraine medications with BuzzRx?
Yes, you can get discounts on some medicines—including medications to prevent and treat migraine—as long as you have a signed prescription from your doctor.
References:
1. https://medlineplus.gov/ency/article/000709.htm
2. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912a8.htm
3. https://www.migrainetrust.org/living-with-migraine/treatments/medication/
4. https://www.arthritis.org/drug-guide/analgesics/analgesics
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798203/
6. https://www.ncbi.nlm.nih.gov/books/NBK554507/
7. https://medlineplus.gov/ency/article/007484.htm
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612904/
9. https://stanfordhealthcare.org/medical-conditions/brain-and-nerves/headache/faqs.html#
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