Treatment: Triptans Or Ditans
Triptans and ditans are the most common medications prescribed for migraine headaches. They are most effective when taken early in an attack. They include almotriptan, eletriptan , frovatriptan , lasmiditan , naratriptan , rizatriptan and sumatriptan and zolmitriptan . People with high blood pressure, heart disease, stroke, and other conditions may not be able to take triptans. And because of possible serious drug interactions, you should talk to your doctor about other medications you take, such as antidepressants or anti-seizure drugs. Side effects of triptans include nausea, dizziness, tingling, numbness, and chest pain.
Discover The Science Behind Your Head Pain
Ever wonder whats happening inside your body to cause migraine pain and discomfort? While researchers still dont know exactly what causes a migraine, you can learn the phases of what happens in your bodyand how you can fight back. The video below provides a visual analysis of how a migraine impacts your brain and your body before, during, and after an attack.
What Causes A Migraine
The exact causes of a migraine are currently not yet known.
It is suspected that migraines are a result of abnormal activity in the brain. This can affect the ways in which the nerves communicate and can affect the blood vessels and chemicals in the brain. It has been found that genetics may make someone more prone to begin sensitive to the triggers which can cause migraines.
The following are triggers which are likely to set off a migraine:
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Take Medication As Soon As You Feel It Coming On
When it comes to medication, you have several options, and the one that’s right for you depends on your own history with migraine, as well as other health concerns. The goal for treatment is to clear the headache completely in one or two hours, meaning the pain does not come back, says Dr. Feoktistov. “We consider successful treatment one where the medication provides pain freedom and allows the patient to get back on their feet and function well,” he says.
NSAID: Some people find that taking anywhere from 200 to 600 mg of ibuprofen or naproxen works. Unfortunately, it’s actually not common for patients to be able to successfully use an over-the-counter NSAID for migraine relief. “For about 80% of patients, NSAIDs will take the edge off the pain but not stop the attack,” he says.
A medication like Excedrin, which combines two pain relieversacetaminophen and aspirin plus caffeine is a slightly better option but patients usually still need something more, he says.
Rescue medications are available in different formulations, such as oral pills, nasal sprays or injectables, but Dr. Feoktistov says that nasal sprays or injectables tend to be faster acting, which can be helpful for migraine pain that rapidly develops, if you wake up in the morning with a migraine or if you also experience significant nausea or vomiting, which may delay absorption of an oral pill.
Selective Serotonin Reuptake Inhibitor Antidepressants
Depression and migraines often go hand in hand, as mood changes are commonly associated with migraine attack, so much so that premonitory depression is sometimes shown to occur before a migraine, ostensibly warning the sufferer of an episode. Id say we deal with mood issues at least 50% of the time in migraine patients, maybe more, mentioned Dr. Charles in the summit interview. Luckily, if doctors find episodic periods of depression in migraine sufferers, they can test whether the mental complications disappear after acutely treating the migraine first.
While SSRI antidepressants, or selective serotonin reuptake inhibitors, have been shown to be effective in the treatment of depression, their role in migraine is a long, rocky road. The current medical hypothesis is that a deficiency of serotonin is somehow involved in migraine triptans, prescription-strength migraine treatment, activate a set of serotonin receptors in the brain. One would think that SSRIs, which look to increase serotonin, would help migraine, but it is not as simple as high serotonin is good and low serotonin is bad, explained Dr. Charles. These drugs react differently in each patient, and may deliver the opposite effect intended, leading to migraine.
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Changes In Or An Irregular Sleep Schedule
The connection between migraine and sleep is undeniable. Sleep renews and repairs all parts of the bodyincluding the brainso it makes sense that when your sleep schedule becomes irregular, you are more prone to migraine attacks. Something else to note when it comes to sleep: Nearly half of all migraine attacks occur between 4:00am and 9:00am, putting people at a greater risk for developing a sleep disorder.
How to cope: Try to go to bed at the same time every night, and aim to get at least 7-8 hours of sleep. Eliminate TV, texting, reading, and listening to music while in bed, and try your best not to nap during the day. This article from the AMF Resource Library has great information and tips on how to make a sleep plan that works with your lifestyle.
The Fastest Way To Relieve A Migraine According To A Headache Expert
Jumping on treatment quickly can prevent a migraine from setting in. Here are your options.
If you get migraines, you know the debilitating affect they have on your day. “A migraine is more than just a headache,” says Alex Feoktistov, M.D., Ph.D., director of the Synergy Integrative Headache Center in Northfield, Illinois. “A migraine is a result of complex chemical changes in the central nervous system that impact blood vessels and nerves of the brain,” he explains.
Migraines differ from headaches because they involve a throbbing on one or both sides of the head that can be intense and are accompanied by other symptoms such as nausea and sensitivity to light and sound, according to the American Migraine Foundation. When the symptoms first start is when you should take action to stop them. Yes, the sooner you stop the pain the less time you have to live with it, but earlier treatment gives patients a better chance of stopping an ongoing migraine attack, Dr. Feoktistov says.
Wait too long, and the migraine becomes more difficult to treat. And unfortunately, left untreated, a migraine lasts anywhere from 4 to 72 hours, notes the National Headache Foundation. So, rather than trying to wait it out or thinking the pain will go away soon, take action now.
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What Does A Migraine Feel Like
Migraines can cause very bad pain that can get in the way of your normal routine. Migraines arent the same for everyone. Some symptoms include:
Throbbing or dull pain on one or both sides of your head
Stomachache or throwing up
Changes in how you see, such as blurry vision or blind spots
Being bothered by light, noise, or smells
Feeling tired or confused
Watch For Dietary Triggers
What you put in your body can have an effect on your migraine headaches. Consume caffeine in moderation, including regular and decaffeinated coffee, over-the-counter medicines and prescription medications.
- Greasy, fried food.
Watch for any reactions to aged cheeses, chocolate, alcohol and fermented and pickled foods, which are also common dietary triggers, says Dr. Young. Your doctor may recommend a therapeutic elimination diet to determine if you have delayed food sensitivities, including gluten.
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What Happens During A Migraine
Every migraine begins differently. Sometimes people get a warning that a migraine is on its way. A few hours or even days before the actual headache, people might feel funny or “not right. They might crave different foods, or feel thirsty, irritable, tired, or even full of energy. This is called a “premonition.”
Some people get auras. These are neurological symptoms that start just before the headache and last up to an hour. An aura is different in every person, but it often affects vision. For example, a person might:
- have blurred vision
- see spots, colored balls, jagged lines, or bright flashing lights
- smell a certain odor
- feel tingling in a part of their face
Once the headache starts, light, smell, or sound may bother people with migraines or make them feel worse. Sometimes, if they try to continue with their usual routine, they may become nauseated and vomit. Often the pain begins only on one side of the head, but it might eventually affect both sides. Trying to do physical activities can make the pain worse.
Most migraines last from 30 minutes to several hours some can last a couple of days.
Tips To Relieve Migraine Pain
Rest in a quiet, dark room. Many people with migraines report sensitivity to light and sound. Make your bedroom dark and quiet, and you may be able to sleep, Good says. Not all headaches respond to sleep, she notes, but the chemicals released in your brain during sleep may help ease your pain. Also, she says, if youre sensitive to sounds, blocking them out could help.
Apply a hot or cold compress. Place the compress across your forehead or the back of your neck. Many of my patients prefer a cold compress, says Lawrence C. Newman, MD, director of the Division of Headache at NYU Langone Medical Center in New York City and a board member of the American Migraine Foundation.
Ice can have a numbing effect. It detracts the brain from the migraine, says Good. Youre stimulating other nerve endings where youre putting the compress.
Some people may prefer a warm compress, Dr. Newman says. Heat can help relax tense muscles. You may also try taking a warm bath or shower.
Smell the lavender. The scent of lavender may help you relax. You can sip some lavender tea, or inhale lavender essential oil, which is available in pharmacies and health food stores. A small study published in European Neurology in 2012 evaluated the use of lavender essential oil in people experiencing a migraine. In the trial, those who inhaled lavender essential oil for 15 minutes reported greater reduction of headache severity than those who did not.
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How Does Your Body Know When To Sleep
You have a circadian rhythm which lasts around 24 hours.
Your body and mind go through a range of changes over this time. It controls your sleep-wake pattern and also changes how alert you are.
Your rhythm mainly responds to changes in light. The body clock in your brain controls this. In the evening, it starts to get dark and your eyes signal this to your body clock. Your body clock then tells the brain to release the hormone melatonin. This makes you sleepy. When it gets lighter, the brain reduces the amount of melatonin it makes. This starts to wake you up. However, we each have a slightly different rhythm which is why some people are more alert in the morning and others, later.
Even within the states of sleep and wakefulness, there are faster, shorter cycles of brain activity.
The American Migraine Foundations Guide To Triggers & How To Manage Them
The sudden onset of a migraine means a dark room, bed and a cool towel for most of us. While these seem to come out of nowhere, many will find that there are usually some signs that a migraine attack is on its way. These signs can reveal a pattern in your symptoms, and even provide you with preventative tools for managing migraine. Everyone has different triggers, but there are a few common culprits that affect a large number of people living with migraine. When you can identify your triggers, you are one step closer to effectively managing your migraine and avoiding future attacks.
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Beware Of Hormonal Changes
Hormones play a significant role in terms of migraines. Many women tend to experience more migraine headaches during, or just before, their menstrual period. Women should be especially vigilant with their diet and exercise habits during this time. This will ease symptoms before they begin. According to the Mayo Clinic, oral contraceptives and hormone replacement therapy may increase the frequency and severity of migraines. Some women may find relief by switching to another form of birth control, while others may find they have fewer migraines while taking birth control.
A Headache Vs A Migraine
A migraine is a vascular headache that occurs when blood vessels on the surface of the brain are irritated and swollen. When these blood vessels are impaired and unable to pulsate properly, they send pain signals to the brain, says the National Headache Foundation . This can cause the eye, temple, and/or face, and sinus area to throb.
According to the NHF, 37 million Americans suffer from migraines. In the 2010 Global Burden of Disease Survey, migraines were listed as the seventh biggest disabler. Migraines may be hereditary, too: 70 to 80 percent of sufferers say migraines run in their families.
The most common type of migraine is one without aura, or visual disturbance. These can last anywhere between 4 and 72 hours, and possibly cause nausea and sensitivity to light and/or sound. If its a migraine with aura, the sufferer may temporarily see spots or lose vision altogether, experience numbness, and have difficulty with speech before the actual pain kicks in.
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Try To Relax In A Dark Quiet Space
Untreated, it’s likely your migraine will evolve and the throbbing pain may progressively get worse. In addition to medication, there are other things you can do. “I do recommend patients take medication as soon as they can and then take it easy,” Dr. Feoktistov says. Here are 4 things you can do:
- Lay down in a dark, quiet room for 30 minutes.
- Take a power nap for 30 to 40 minutes.
- Eliminate other irritants or migraine triggers such as bright lights or loud noises. “Migraine patients almost universally become sensitive to light and sound. It’s important to control these factors as best you can,” he says.
- Stay hydrated. Drinking a lot of water can help you recover from an episode more quickly, he adds.
Changes In The Weather
Storms, excessive heat and changes in barometric pressure are common weather-related migraine triggers that can lead to a migraine attack. High humidity and heat can easily lead to dehydration, another common trigger.
How to cope: We cant control the weather, so if the current conditions are not favorable for your migraine, stay inside or adjust your schedule accordingly. If theres an errand you need to run and its the middle of July in Arizona, take care of it in the morning before it gets too hot!
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When To See Your Doctor
In most cases, episodic headaches will go away within 48 hours. If you have a headache that lasts more than two days or that increases in intensity, you should see your doctor for assistance.
If youre getting headaches more than 15 days out of the month over a period of three months, you might have a chronic headache condition. You should see your doctor to find out whats wrong, even if youre able to manage the pain with aspirin or ibuprofen.
Headaches can be a symptom of more serious health conditions, and some do require treatment beyond OTC medications and home remedies.
Dont Go Looking For Trouble
No two migraines are exactly the same, and no two people will experience the exact same headache.
Tinsley, who also gets these terrible headaches, recommends keeping a food and migraine journal to find any common denominators. He recommends starting by eliminating the most common triggers, then using trial and error to determine your perfect storm for a migraine.
Sometimes its a combination of these things that trigger the migraines, he says. For example, your migraine triggers can be a mix of things you can and cant control: a stressful week, a drop in pressure due to a storm, a drink with dinner and chocolate cake for dessert.
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Articles On Living With Migraine & Headache
Researchers are still trying to figure out why some people get migraines and others don’t.
What experts do know is that certain things can be migraine triggers for some people. Staying away from those things can lower your chances of getting one. Here are some things to avoid.
Donât stick with things that trigger headaches. Things that trigger a migraine are different for everyone. Once you figure out what yours are, stay away from them, or talk to your doctor about how to manage them better. Common ones include stress, exercise, fatigue, and medications. Women often get them from changes in hormones just before their periods. Alcohol and caffeine can bring them on, as can foods like cheese, chocolate, artificial sweeteners, cured meats, and things with a strong smell.
Don’t skip meals. Being hungry to the point that you feel shaky can bring on a migraine. Some researchers think low glucose levels may cause changes in your brain that bring them on.
Don’t take pain meds for more than 3 or 4 days. Over-the-counter medications like acetaminophen , aspirin, ibuprofen , or a combination of acetaminophen, aspirin, and caffeine can sometimes help ease migraine headaches. It’s best to take one of these as soon as you feel a migraine coming on. But using them for more than a few days in a row can lead to “rebound headaches.” Your body starts expecting the pain medication, and migraines can happen if you don’t have it in your system.
TRC: “Food, Herbs, Supplements.”