When we acknowledgment migraine treatment, we accessible a Pandora’s box. There are altered migraine treatments for altered types of headaches, and some of the aforementioned migraine medications are as well accepted analysis for altered types of migraines.
If your one of the advantageous ones that has a migraine occasionally “maybe advantageous wasn’t the best chat to use, but abounding ache every day” something as simple as Excedrin migraine or Advil migraine, with a few hours lying down in a absolutely allowance may be all you need.
But if your migraines are frequent, one a anniversary of so, they charge adapted treatment.
What Cause Migraine ?
The exact cause of migraine is not fully understood. Most researchers think that migraine is due to abnormal changes in levels of substances that are naturally produced in the brain. When the levels of these substances increase, they can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.
Genes also have been linked to migraine. People who get migraines may have abnormal genes that control the functions of certain brain cells.
Experts do know that people with migraines react to a variety of factors and events, called triggers. These triggers can vary from person to person and don’t always lead to migraine. A combination of triggers — not a single thing or event — is more likely to set off an attack. A person’s response to triggers also can vary from migraine to migraine. Many women with migraine tend to have attacks triggered by:
- Lack of or too much sleep
- Skipped meals
- Bright lights, loud noises, or strong odors
- Hormone changes during the menstrual cycle
- Stress and anxiety, or relaxation after stress
- Weather changes
- Alcohol (often red wine)
- Caffeine (too much or withdrawal)
- Foods that contain nitrates, such as hot dogs and lunch meats
- Foods that contain MSG (monosodium glutamate), a flavor enhancer found in fast foods, broths, seasonings, and spices
- Foods that contain tyramine, such as aged cheeses, soy products, fava beans, hard sausages, smoked fish, and Chianti wine
- Aspartame (NutraSweet® and Equal®)
To pinpoint your migraine triggers, keep a headache diary. Each day you have a migraine headache, put that in your diary. Also write down the:
- The time of day your headache started
- Where you were and what you were doing when the migraine started
- What you ate or drank 24 hours before the attack
- Each day you have your period, not just the first day (This can allow you and your doctor to see if your headaches occur at the same or similar time as your period.)
Talk with your doctor about what sets off your headaches to help find the right treatment for you.
Migraine Treatment Medications
Analgesics, such as acetaminophen and NSAIDs, should be considered drugs of choice for acute treatment of mild to moderate migraine headaches without vomiting or severe nausea. Migraine has no cure. But your migraines can be managed with your doctor’s help. Together, you will find ways to treat migraine symptoms when they happen, as well as ways to help make your migraines less frequent and severe. Your treatment plan may include some or all of these methods.
Medicine. There are two ways to approach the treatment of migraines with drugs: stopping a migraine in progress (called “abortive” or “acute” treatment) and prevention. Many people with migraine use both forms of treatment.
Triptans, calcitonin gene-related peptide (CGRP) antagonists and ditans require prior authorization for the acute treatment of migraine headaches that are causally related to an industrial injury or occupational disease:
Triptans have an established record of safety and efficacy and are considered first-line agents. Generic triptans are coverable upon request. Triptans, which work by balancing the chemicals in the brain. Examples include sumatriptan (Imitrex®), rizatriptan (Maxalt®), zolmitriptan (Zomig®), almotriptan (Axert®), eletriptan (Relpax®), naratriptan (Amerge®), and frovatriptan (Frova®). Triptans can come as tablets that you swallow, tablets that dissolve on your tongue, nasal sprays, and as a shot. They should not be used if you have heart disease or high blood pressure.
- CGRP Antagonists
Due to a lack of long-term safety and efficacy data and comparative evidence versus triptans, rimegepant and ubrogepant are considered second-line agents. The coverage of CGRP antagonists requires previous trials of at least two triptans, unless the patient has a contraindication to their use.
Lasmiditan lacks long-term safety and efficacy data and comparative evidence versus triptans. In addition, lasmiditan is associated with central nervous system side effects, such as drowsiness and dizziness, and is a controlled substance. As such, ditans are considered third-line agents and require previous trials of at least two triptans and at least one CGRP antagonist, unless trials are contraindicated.
- Fioricet – Fioricet contains a combination of acetaminophen, butalbital, and caffeine Acetaminophen is a pain reliever and fever reducer. Butalbital is in a group of drugs called barbiturates. It relaxes muscle contractions involved in a tension headache. Caffeine is a central nervous system stimulant. It relaxes muscle contractions in blood vessels to improve blood flow. Fioricet is used to treat tension headaches that are caused by muscle contractions.
Most acute drugs for migraine work best when taken right away, when symptoms first begin. Always carry your migraine medicine with you in case of an attack. For people with extreme migraine pain, a powerful “rescue” drug might be prescribed, too. Because not everyone responds the same way to migraine drugs, you will need to work with your doctor to find the treatment that works best for you.
Migraine Prevention Medications
Some medicines used daily can help prevent attacks. Many of these drugs were designed to treat other health conditions, such as epilepsy and depression. Some examples are:
- Antidepressants, such as amitriptyline (Elavil®) or venlafaxine (Effexor®)
- Anticonvulsants, such as divalproex sodium (Depakote®) or topiramate (Topamax®)
- Beta-blockers, such as propranolol (Inderal®) or timolol (Blocadren®)
- Calcium channel blockers, such as verapamil
- Gabapentin – Gabapentin capsules, tablets, and oral solution are used along with other medications to help control certain types of seizures in people who have epilepsy. Gabapentin capsules, tablets, and oral solution are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles). Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Gabapentin is in a class of medications called anticonvulsants. Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
These drugs may not prevent all migraines, but they can help a lot. Hormone therapy may help prevent attacks in women whose migraines seem to be linked to their menstrual cycle. Ask your doctor about prevention drugs if:
- Your migraines do not respond to drugs for symptom relief
- Your migraines are disabling or cause you to miss work, family activities, or social events
- You are using pain-relief drugs more than two times a week
Lifestyle Changes Preventions for Migraine
Practicing these habits can reduce the number of migraine attacks:
- Avoid or limit triggers.
- Get up and go to bed the same time every day.
- Eat healthy foods and do not skip meals.
- Engage in regular physical activity.
- Limit alcohol and caffeine intake.
- Learn ways to reduce and cope with stress.
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