There is currently no cure for migraine, but there are established guidelines to help manage the symptoms. There are 2 established types of treatment perceived as effective: treatment of acute migraine and preventive treatment of migraine. In addition to this, lifestyle and non-medical treatments, as well as symptom management tips, can be useful in preventing and/or alleviating headache.
Treatment of acute migraine
Most patients who suffer from episodic migraines have recourse to acute medications to help relieve mild to moderate pain. Acute medications include analgesics (painkillers), ergotamines, and triptans. Simple analgesics are nonsteroidal anti-inflammatory drugs (NSAID). These are considered non-specific migraine medications as they operate to relieve pain in general, reduce inflammation, and bring down a high temperature. Examples of FDA approved NSAIDs include Ibuprofen, Naproxen, Diclofenac, and Celecoxib.
Ergotamines and triptans, on the other hand, are more migraine-specific medications as they have a direct effect on the pain pathway involved in migraine without effect on any other bodily pain. Triptans work by stimulating a neurotransmitter in the brain called serotonin to reduce inflammation and stop the headache. Examples of FDA approved triptans include Almotriptan, Eletriptan, Frovatriptan, Naratriptan, Rizatriptan, Sumatriptan, and Zolmitriptan. These are most effective when taken early in a migraine attack when the pain is still mild.
It is advised to use medications for acute migraine with moderation as they might cause side effects such as nausea, vomiting, rebound headaches and progression to chronic headache disorders. Often, anti-nausea and other symptom-preventing medications are given alongside the migraine medication to prevent such side effects.
Preventive treatment of migraine
Preventive treatment of migraine is important for patients who suffer from chronic migraine or who are known to be resistant to medications for episodic migraine attacks.
Chronic migraine is defined as headache occurring on more than 15 days per month for more than 3 months, with migraine features on at least 8 of those days. Because an adequate choice of preventive medications depends on many factors such as high blood pressure, asthma, diabetes, or pregnancy, it is essential that the choice of a preventive medication be rightly assessed from individual to individual.
In the case of preventing episodic migraines, it is generally agreed that preventive treatment is warranted if migraine occurs at least once per week or on 4 or more days per month. Most preventive medications for migraine have been secondarily adopted as treatments for migraine and include blood-pressure medications (beta-blockers, calcium channel blockers), antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors), anticonvulsants.
In any case, preventive treatment should be established in consultation with a doctor and not be self-prescribed as it can lead to serious side effects.
Lifestyle and non-medical treatment
There are ways in which patients can help themselves prevent migraine attacks by making lifestyle changes. Maintaining a balanced diet can help to ease and prevent migraine attacks. Some people have reported that their symptoms appear when they eat certain foods, however, these vary from person to person. Frequently reported food triggers include alcohol (especially red wine), artificial sweeteners, caffeine withdrawal, chocolate, processed meats and foods. In addition to this, regular exercise can also help reduce the frequency of migraine attacks since it reduces stress, helps to regulate sleep and combat obesity; all factors which, if kept unregulated, have been linked to migraine attacks. Yoga can be a good start to ease into a regular exercise routine.
Migraine management tips
In the case of a migraine attack, there are several non-medical ways that can help you manage and partially alleviate your symptoms. Many migraine patients report seeking out a dark room where they can lie down, close their eyes and relax. This can help ease the tension. It is generally advised to relax and avoid stress and get good quality sleep. Massaging your neck and temples can also help sooth the tension by improving blood flow. Another way to relieve tension headaches is by applying a heating pad or a warm cloth around your neck.