A migraine is defined as a throbbing or pulsating headache that is limited to one side of the head (a unilateral headache). They are usually characterised by severe pain and are accompanied by nausea and hypersensitivity to light and sound. The exact causes of migraines are scientifically unclear, but certain triggers have been recognised that mark the onset of a migraine attack. A migraine is also often preceded by a sensory warning sign. Known as an ‘aura’, this includes flashes of light, blind spots or tingling in your arm or leg.
Three times as many women are affected by migraines than men. Some people may have several migraine attacks in a month, while others will only suffer from a few throughout their whole lives. They occur at any age, but are most likely to begin between the ages of 10 and 40, diminishing after the age of around 50.
Prophylactic medication, meaning preventive, is aimed at reducing the number of migraines and is adopted for patients who have more than three attacks of a headache in a month. There are several forms of medications used in this form of treatment. The main types include:
Beta blockers relax blood vessels. The widening of blood vessels in the head (cerebral vessel vasodilatation) is a prominent feature of a migraine attack, so beta blockers, such as propranolol and atenolol, can be an effective treatment in some cases.
Anti-seizure medication, such as valproic acid and topiramate, are predominately used for the treatment of epilepsy. However, although it is unclear how they work to combat migraines, they can reduce the number of migraines suffered each month by more than a half.
Calcium channel blockers
Calcium channel blockers reduce the amount of narrowing of the blood vessels. Medication such as verapamil and amlodidpine have reduced the amount of migraines in some cases.
Tricyclic antidepressants, such as amitriptyline and desipramine, which are usually used to treat depression, can be effective in preventing headaches. The pain-relieving properties of these medications may reduce the duration and frequency of the attacks, while also improving associated trouble with sleeping.
Abortive medication aims at reducing pain caused by an attack. Mild and infrequent migraines are mostly relieved with mild medications and home care remedies, such as cold packs. A few of these include:
Analgesic medication, also known as ‘anti-neuropathic’ medication, is an effective way of treating the painful symptoms of migraines. Neuropathic pain is a very specific type that is usually defined as pain that originates due to an injury to, or inflammation within, the central or peripheral nervous system, although it could also arise from a nervous system that is not functioning correctly. Although the causes of migraines are not fully understood, there is an obvious connection between their symptoms and the nervous system. Analgesic medication often prescribed for migraines includes aspirin and ibuprofen.
Serotonin Receptor Antagonists
Also known as ‘Triptans’, these medications narrow the blood vessels in the brain to relieve swelling. They are known to quickly and effectively relieve headache pain, sensitivity to light and noise and nausea and vomiting associated with migraines. They are especially helpful with moderate to severe headaches that interfere with the migraine sufferer’s ability to perform daily tasks.
Ergotamines are not as effective as Triptans, but can also be used to stop or treat symptoms of an emerging headache by narrowing the blood vessels in the brain. Dihydroergotamine is often used.