Nonprescription Treatment Options For Migraine
Emily M. Ambizas, PharmD, MPH, CGPAssociate Clinical ProfessorCollege of Pharmacy & Health SciencesQueens, New YorkClinical Specialist, Rite Aid PharmacyWhitestone, New York
Alberto H. Ambizas, PharmD, CGPClinical Pharmacy SupervisorNorthport, New York
US Pharm. 2016 41:31-34.
Migraine headache is a common, debilitating condition affecting nearly 1 out of 7 Americans annually.1 This condition affects more women than men, and prevalence is highest during peak productive years, between the ages of 25 and 55 years.2 Migraine accounts for the majority of the 5 million headache visits to U.S. emergency departments annually.3 It has a major impact on quality of life more than 90% of migraine sufferers find it difficult to work or function normally during an attack, accounting for more than 150 million missed worked days, with an annual cost to employers exceeding $14 billion.4,5 In addition, migraine headache is ranked as the sixth highest cause of disability worldwide.6
Pharmacists are in a unique position to help care for patients suffering from migraines. They are often the first healthcare professionals that patients will encounter when seeking relief for their migraine as many as 57% of patients self-medicate with OTC products.7 It is important for pharmacists to understand when and how to use OTC products for the management of migraines as well as when patients require referral to their healthcare provider.
Whats A Migraine Cocktail
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Just a heads up that the post below may have affiliate links.
What Is In A Migraine Cocktail
The components of the migraine cocktail or rescue therapy vary considerably depending upon the emergency room or urgent care center where youre getting them. A typical rescue approach would include an analgesic and an anti-nausea agent and, in some cases, an anti-inflammatory medication, such as a steroid or something non-steroidal. Some healthcare providers will include magnesium as part of the cocktail or rescue approach.
Intravenous fluids may be useful as part of a rescue plan, especially if youre dehydrated from vomiting or poor intake.
It is generally recommended to use migraine-specific acute therapies, like a triptan, gepant, or lasmiditan, as a first line approach before going to the less migraine-specific components of a migraine cocktail or rescue therapy. Often people have tried those before they go to the urgent care or emergency department but not always.
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Which Migraine Medications Are Available Over The Counter
First, it helps to know what types of migraine medications are available over the counter and which ones youll need a prescription for.
OTC migraine medications include:
Ergot alkaloids, like ergotamine tartrate
Serotonin 1F receptor agonists like Reyvow
CGRP antagonists like Ubrelvy
The medications listed above are used to treat migraines while youre having one. There are other prescription medications that you can take to help prevent migraines from occurring.
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Devices Used For The Treatment Of Attacks
The gammaCore vagus nerve stimulator has been shown to treat both migraine and vestibular migraine attacks . The Cefaly device has also been shown to treat migraine and vestibular migraine attacks. A study conducted on Nerivio showed that it was effective in treating migraine pain and the most bothersome symptom at the 2 hour mark. Read our review of the Allay Lamp which is a new addition to the market. This lamp, which has a narrow band of green light, has been shown to be soothing for people with migraine. Personally, I find it effective at reducing my overall migraine symptoms.
|Devices Acute Migraine|
|Narrow band green light therapy||Allay Lamp|
Straight Up: Solo Drugs That May Help
Any single ingredient used in a migraine cocktail might be enough to soothe your pain on its own. A few solo meds that might help:
- ergot alkaloids
You can also take preventive measures against chronic migraine:
- Botox. Yep, these wrinkle-freezing facial injections might also help prevent some folks migraine attacks.
- Blood pressure meds. Beta-blockers and calcium channel antagonists might help prevent migraine attacks.
- Antidepressants. *Some* antidepressants can help prevent migraine attacks.
- Antiseizure meds. Options include valproate and topiramate .
- CGRP inhibitors. These are injections that help some people avoid future migraine attacks.
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Migraine Cocktail: A Comprehensive Guide
This post may contain affiliate links. Migraine Strong, as an Amazon Affiliate, makes a small percentage from qualified sales made through affiliate links at no cost to you.
According to the Migraine Research Foundation , migraine affects one billion people across the globe, 39 million in the United States alone, and its the 6th most disabling illness in the world. Finding an effective migraine cocktail is one of the single most important things that anyone with migraine can hope to find.
Everyday we have conversations about acute medications in the . Which ones work best, what can be combined together and just how many triptans are there on the market? I hope having all of this information in one place will be helpful for anyone treating migraine or trying to put together an effective migraine cocktail. Ill also share some migraine cocktails that we personally use and the medications that are typically used to treat vestibular migraine.
** Disclaimer: This is written from the perspective of the patient and patient-advocate. This is not a substitute for medical advice. The information here will help you understand your many options so that you are better prepared for the next conversation you have with your healthcare provider.
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Migraines and headaches don’t have to get in the way of you enjoying your life. An IV for migraines could help you get fast relief from symptoms. So let us help you with a customized IV with migraine medication. We’ve designed a menu of IV packages that are affordable and effective. You can also join our VIP program for additional deals and specials.
Call or text Rocky Mountain IV Medics at 720-987-2155 to schedule an IV therapy appointment now. You can also reach out online to learn more and book a treatment.
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Try A Different Temperature
There are two tried-and-true methods that most of us turn to when facing an injury and its pain: hot or cold therapy. While it might seem odd to consider placing an iced or heated pack on your head, it can make all of the difference in just a few minutes.
As Stress Knots and the Mayo Clinic both recommend, simply choose which works best for your migraines. When you apply heat, your muscles will relax, and pain will lower. If you choose icy cold, you will numb the areas most in pain to all that they are feeling.
Try out one of these headache hat or other ice pack headbands â keep the included ice pack in the freezer so it’s cold when pain strikes. If heat works for you, try this moist heat headache wrap or eye mask.
Image via Shutterstock
Triptans The Most Common Migraine Cocktail Ingredient
Triptans are usually the go to medication for migraine after the typical over the counter medications have been tried. Triptans act by constricting blood vessels and blocking the release of calcitonin gene-related peptide from the nerves activated during migraine. CGRP cause blood vessels to swell and initiates the cascade of inflammatory events leading to pain. There are currently seven different triptan medications with several different formulations. Most patients receive sumatriptan as the first triptan to try.
Unfortunately, if side effects are too annoying or the medication doesnt work, people are often left with the idea that triptans dont work for them. The involvement of digestive issues can also cause the migraine medication to not be absorbed. Experimenting with injection and nasal spray formulations may prove to be the difference in getting relief and not. Also, all triptans are formulated differently. If sumatriptan doesnt work, its worth trying eletriptan , rizatriptan , almotriptan or zolmitriptan . Trying these in conjunction with other medications in a migraine cocktail can make them more effective as well. Triptans should be limited to no more than 10 days a month or approximately twice per week to avoid rebound headaches.
|Acute Medication Triptans|
|2.5-5mg dissolvable tablet nasal spray 2.5-5mg|
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Make A Great Remedy For Migraine Headaches Using Chamomile
Edited by Nerissa Avisado, Eng, Lynn
Chamomile has been used for medicinal purposes for centuries. In fact, both the German and Roman cultures have held it to a very high reputation among plant-based medicines for over 2,500 years now. Chamomile was highly regarded by ancient herbalists because of its curative effects against a variety of ailments, including infant colic, menstrual cramps, insomnia, toothache, and indigestion, among many others. Today, chamomile continues to be a well-known medicinal plant in many countries. Despite advances in medicine, many people still rely on the natural yet effective anti-inflammatory, analgesic, antimicrobial, sedative, anti-spasmodic, and carminative properties that this fragrant herb offers.
I Get Migraines That Cause Me To Get Dizzy And Throw Up Will These Migraine Remedies Help Me
To be honest, serious chronic migraines are difficult to treat. These natural remedies will probably be most effective if you use them right away when you feel a migraine coming on.
Work with a health professional to develop a plan for long-term migraine treatment and find out how you can include natural remedies within that approach.
Migraine Symptoms & Treatment
Migraines are notoriously painful headaches with a cluster of symptoms that range from mild to severe. The most common symptoms include:
- Hypersensitivity to light
- Throbbing/pulsing headache
Treatment varies but typically involves the use of prescription medication. Other treatments may include over the counter medications like Ibuprofen or Tylenol. There are many other ways people try to alleviate their symptoms, ranging from dietary modification to supplementation.
Iv Hydration Therapy For Migraines And Headaches
For those that suffer from migraines, learning how to avoid triggers and prevent episodes is key. But sometimes, despite your best efforts, a migraine can occur anyway.
The pain, nausea, and sensitivity to light and sound can disable you completely, preventing you from participating in your daily life for days or even weeks at a time.
Thankfully, advancements in migraine treatment options have provided the answer that so many migraine sufferers have been desperately searching for: fast, effective migraine relief with IV hydration therapy.
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Caution For Pregnant Women
Some medications used in the emergency treatment of migraine headaches are known to cross the placenta of women who are expecting and cause possible harm to a developing baby. These include:
- NSAIDs: These are not considered safe for women in the third trimester of pregnancy, at which time these drugs can interfere with the healthy development of a baby’s lungs, cause low levels of amniotic fluid, or slow or stop labor during childbirth.
- Dihydroergotamine: Also known as an ergot alkaloid, this drug is on a long list of medications cited by the AHS panel as having too little available information to recommend or not recommend for pregnant women. Brand names in this class include D.H.E. 45 and Migranal.
- Opioids: Both oxycodone and morphine are opioid medications that carry a high risk of abuse and addiction. Studies have shown that opioids are also less effective at terminating migraines than the antiemetic, metoclopramide.
- Valproate: This anti-seizure drug is sometimes ordered to prevent recurrent migraines. Valproate is considered highly teratogenic, and is banned in many countries for use in pregnant women and women of childbearing age.
Abortive Therapy For Headaches
How does abortive therapy work?
You take abortive therapy medications early during a headache. Theyre usually used for migraine headaches. These drugs stop the process causing headache pain. They help reduce headache symptoms, such as nausea, vomiting and sensitivity to light and sound.
For best results, take these medicines when you first notice the migraine. If you get a migraine aura , you may need to avoid some of these medications. Talk to your healthcare provider to figure out which medications are right for you.
Can IV drugs help stop a migraine?
Some headaches especially migraines last for more than 24 hours and dont respond to other abortive medications. In these situations, your healthcare provider may recommend you get medication at an infusion site.
This site is usually a set of rooms at a hospital or clinic where people receive IV drugs. A nurse monitors the people receiving infusions. Generally, IV drugs can end the migraine attack, even when other abortive medicines were unsuccessful. You may be at the infusion site for a few hours or a full day, depending on your symptoms.
Can children take abortive therapies?
The FDA has approved some abortive therapies for teenagers but none for younger children. Talk to your childs healthcare provider to figure out the best way to treat headaches.
What abortive therapy headache medicines are available?
Medications that can stop migraine headaches include:
Generic name: Ergot, dihydroergotamine, mesylate
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Severe Migraines Deserve An Er Visit
Go to the ER if you are experiencing severe migraine symptoms, or symptoms such as confusion, fever and vision changes, neck stiffness, trouble speaking or numbness or weakness, even if other symptoms of migraine are present . Always go to the ER if a headache begins suddenly and reaches maximum intensity within a minute or two. If you recognize your symptoms as those of a typical migraine attack, you may be better served to treat yourself at home, based on the treatment plan you and your headache specialist have drafted together. If you dont have a rescue plan, then speak with your physician to develop one so that you can avoid going into the ER. A trip to the ER may even exacerbate a migraine or provide only temporary relief only to have the pain roaring back within hours after leaving the ER.
Are They Safe For Kids
And guess what? The same meds used in a grown-up migraine cocktail can help relieve kids migraine attacks. Yay! Fun for the whole family!
Just make sure you tell the ER doc about your childs health history and underlying conditions before suggesting a migraine cocktail. And of course, rely on the doctors judgment for the best treatment and dose to help your little one find relief.
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Question: What Is The Migraine Cocktail
A migraine cocktail is a combination of medications thats given to treat severe migraine symptoms. The exact medications used in a migraine cocktail can vary, but it typically includes triptans, NSAIDs, and antiemetics. A migraine cocktail is also available in OTC medication.
Dealing With Intractable Migraine
The migraine is still here and I do not know when or if it will go away. If things start to progress and worsen, I will just go through my steps again. It is an ongoing process, one that may repeat itself a few times a year. This is what having chronic intractable migraine looks like for me. I wish it wasn’t my normal, but it is. Here’s hoping one day a new normal comes my way.
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Which Type Of Girl Is Best In Bed
13 things that make a woman good in bedDont make fun of his buddy down below. Get good at oral sex. Be confident. Drink those fancy drinks. Revel in the taste of food. Enjoy those flavors. Exercise. If a woman takes care of her body, she is usually quite confident about it. Practice your kissing skills. This is a big one.More itemsNov 24, 2020
Whats In A Migraine Cocktail
A migraine cocktail isnt a drink. Although, if you know of a drink that will take away a migraine please share it in the comments. A migraine cocktail is a mixture of medications that when taken together can greatly reduce or eliminate a migraine.
If youve been to the ER with a migraine they may have given you a migraine cocktail. But, just what is a migraine cocktail? Whats in it? I did a little research and this is what I found.
I had a severe migraine was taken to the hospital.Dr there told me if you feel another one come to ER tell them you need a migraine cocktail. Have you ever heard this ? And what is it ?
I received the above question from a reader and even though Ive been in the ER with migraines before, migraine cocktail wasnt a term Id heard used there or elsewhere, so I had to do a little research.
Migraine Cocktails in the ER
Ive been in the ER a couple of times with migraines and I can tell you that what theyve given me is, at best, a combination of nausea meds with either a triptan or something like hydrocodone. Every time theyve also sent me home with a script for Hydrocodone .
Ive found this amusing each time because quite simply narcotics dont do anything for a migraine. It seems that most ER docs dont have a clue about migraines or how to best treat them, then again a lot of neurologists dont even grasp the concept.
7% received a triptan 65% were given a migraine cocktail 24% were treated with opioids.
Migraine Cocktails at Home
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