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.
What Causes A Migraine
The cause of migraine headaches is complicated and not fully understood. When you have a headache its because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. Its unclear why your nerves do that.
What Are Some Risks With Otc Migraine Medications And Who Should Avoid Them
With all OTC migraine medications, theres a risk of developing whats called a medication overuse headache . MOH is a headache that happens if you use OTC migraine medications for too long, or more than 10 to 14 days a month. If you find yourself needing migraine relief this often or more, talk to your healthcare provider about whether you might need a stronger prescription migraine treatment.
In addition to preventing MOH, youll want to take a few more precautions depending on the specific ingredient your OTC migraine treatment includes.
You May Like: Can Migraines Cause Seizure Like Symptoms
What Are The Different Types Of Migraine Medications
Migraine medications fall into two major categories.
- The first contains drugs that abort or stop migraines from progressing once they begin. The earlier these drugs are used in a migraine attack, the better they work.
- The second category contains drugs that prevent migraines from happening.
- Or combinations of these
One drawback to using analgesics and NSAIDs is that taking them daily can make headaches worse due to medication overuse.
Prescription drugs used to provide relief from pain include
- NSAIDs and
Like over-the-counter medications, prescription drugs often come in combinations.
- A barbiturate called butalbital is often used in combination with acetaminophen, and
- caffeine with or without codeine .
While analgesics, NSAIDs, and narcotics relieve pain, they don’t address the underlying physiology — primarily the dilation of blood vessels in the brain. Two classes of migraine drugs are:
- ergotamines and
Ergot alkaloids — such as ergotamine tartrate and dihydroergotamine mesylate — are potent drugs that constrict blood vessels. Because nausea is a possible side effect of these migraine drugs, some people take ergotamines in combination with other drugs to prevent nausea.
What Questions Should I Ask My Healthcare Provider
- Will my child grow out of their migraines?
- What medications do you recommend for me?
- What should I change about my lifestyle to prevent my migraine headaches?
- Should I get tested?
- What type of migraine do I have?
- What can my friends and family do to help?
- Are my migraines considered chronic?
A note from Cleveland Clinic
Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
You May Like: Why Does Caffeine Help Migraines
Strongest Migraine Medication Over
When discussing strength, we often refer to how much of a medication is given per dose.
Many of these OTC migraine medications are given in high doses. For example, the recommended dosages for aspirin and acetaminophen are typically around 1,000 mg.
However, when thinking about strength, you may also be considering how strongly these medications act against your migraine symptoms.
In this case, an argument can be made for the aspirin, acetaminophen, and caffeine combination. Older research has found that the combination of these three ingredients has a greater effectiveness than each individual ingredient alone.
Overall, its important to remember that the medication that most effectively alleviates acute migraine symptoms can vary by person. Because of this, focus on finding the treatment that best addresses your symptoms.
How Do I Know If Otc Medications Are Right For Me
Its always a good idea to check with your healthcare provider about any medicines you are taking, even those that are OTC. You may have other conditions that affect whether these medicines are right for you. The following chart can provide some clues as to whether or not OTC medications are right for you.
|Probably okay to use*|
Also Check: How To Tell If Someone Is Faking A Migraine
Attack Phase: The Headache Begins
The attack portion of a migraine can last from a few hours to several days. During this phase, youÃ¢ll probably want to rest quietly and find it hard to do your normal activities.
The pain of a migraine:
- Usually begins above the eyes
- Typically affects one side of the head, but it may happen to the entire head or move from one side to the other. It may also affect the lower face and the neck.
- Tends to feel throbbing
- May throb worse during physical activity or when you lean forward
- May get worse if you move around
Other symptoms that might happen during this phase:
Whats A Rebound Headache
Some headaches rebound because you use medications too much. Then you need to take even more medication, which makes the pain worse. This cycle can happen with:
- Taking pain relievers more than two days a week.
- Overusing abortive medications, with headaches returning after the last dose.
Talk to your healthcare provider about stopping medications. If you stop, the pain may improve over the next six to 12 weeks.
Botulinum Toxin A Injections
Used for: wrinkles, chronic daily headaches over 15 days per month. This drug is injected into muscles at the sites of pain in the neck, face, and head in doses up to 100 units every 3 4 months.
Common side effects: mild pain, aching and bleeding at the site of injection, increase in headache condition, drooping eyelid, and dry mouth.
Here are the links to the articles I’ve already written on Botox:
Medications used to treat migraines also treat other ailments. They are not specific just for migraine treatment. Analgesics, narcotics, and barbiturates can be addictive, so they are used less in most instances by your doc.
Your doctor might try you on other drugs like a narcotic analgesic – Codeine which can also be used as a “backup” for the occasions when a specific drug does not work.
This would be worth checking on it’s own to see if it helps at all first.
My doctor separated Codeine out for me to use, it didn’t touch the side of my pain, so I no longer take it.
This is good for me as it caused constipation. Who wants that?
Holly’s Helpful Tip: Get Codeine in a separate script and use it alone to see if it works to stop your pain phase. If it doesn’t… don’t use it or anything with Codeine in it. It’s addictive and causes constipation which is not good for you at all.
Our Choice For The Best Medicine For Headaches
Our choice for the best medicine for headaches may not work for some, but it is the safest among the products on the list. Our choice is Preventa Migraine from Family Tree Remedies. While it is not a medicine, it is just as effective as the others on the list.
One of the things that make some people hesitate to purchase medicine is the side effects that come with it. Therefore some people would rather look for other alternatives for alleviating their pain and discomfort. Preventa Migraine is one of the products that you can trust because you know it is made of all-natural ingredients. You know that it does not contain aspirin and caffeine and other harmful and artificial ingredients. Moreover, what makes it the best medicine for headaches is the fact that it works. It gives you satisfactory results.
Likewise, Preventa Migraine will not only alleviate you from the symptoms of a headache since it is a supplement, it does just that: it supplements what you lack or do not have. As such, you will be stronger in time and will not have to worry about frequent headaches and migraines. Your body will be prepared even before it comes. Like what most people say, prevention is the best cure.
best medicine for headaches
blending, or applying the best medicine for headaches at some particular time or in some particular proportion.
You May Like: Does Cream Of Tartar Work For Migraines
What Are The Treatment Options To Prevent Menstrual Migraine
Medications used to treat menstrual migraine are the same as those used to treat other forms of migraine. However, your doctor may recommend other treatments to be take regularly, in order to prevent or reduce the severity and frequency of menstrual migraines.
Tricyclic Antidepressants For Vestibular Migraine
Another popular class of medication used to treat Vestibular Migraine is tricyclic antidepressants. Nortriptyline specifically was found to relieve dizziness in 46% of patients who combined the medication with lifestyle changes that included addressing triggers related to diet, behavior, and sleep hygiene
It seems these medications work well for patients who may also have sleep disturbances or who also experience an anxiety component to their attacks. It also appears that medication is even more effective when supported by other areas of treatment, like keeping a sleep schedule and avoiding potential food triggers.
Read Also: Migraine With Fever
Medicines Plus Behavioural Therapy
An interesting research study published in 2010 compared two groups of people who had frequent migraines. One group took a beta-blocker medicine alone. Another group took a beta-blocker but also had a course of behavioural migraine management . BMM included education about migraine, helping to identify and manage migraine triggers, relaxation techniques and stress management. After a number of months the group of people who took the beta-blocker plus BMM had, on average, significantly fewer migraines compared with the group who took beta-blockers alone. Further research is needed to confirm this and to look at BMM combined with other medicines to prevent migraine.
Whats A Migraine Journal
- Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
- The date and time of when the migraine began specifically when the prodrome started, if youre able to tell its happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage youre in and how long it lasts. If theres a pattern, that may help you anticipate what will happen in the future.
- What are your symptoms? Be specific.
- Note how many hours of sleep you got the night before it happened and your stress level. Whats causing your stress?
- Note the weather.
- Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
- Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain youve ever experienced.
- Where is the pain located? One side of your head? Your jaw? Your eye?
- List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
- How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
- Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If youre a woman, are you on your period?
Read Also: How Does Cream Of Tartar Help Migraines
Medicines To Prevent Migraines
Preventive medicines are taken daily to prevent migraine attacks from happening. They are not used to treat an acute attack. Medicines to prevent migraines are an option if you:
- have at least 2 attacks a month
- have significant disability even with suitable treatment for migraine
- cannot take suitable treatment for migraine attacks.
Preventative medicines help to reduce the severity and length of attacks and how often you get them, reduce disruption to your daily activities and reduce overuse of acute medicines. They must be taken every day to be effective. They may take a few weeks to start working. Many different preventive medicines are available. Which one is best for you depends on things such as:
- other medical conditions you have, including high blood pressure, asthma, diabetes or pregnancy
- potential side effects of the medicine
- your response to preventive medicines if you’ve used them before.
Home Remedies For Migraines Using Ginger
According to a 2013 study of Phytotherapy Research, ginger can prove effective in the cure of common migraines at home.
Ginger can block prostaglandins, which are chemicals promoting muscle contractions, impacting hormones and regulating inflammation in your brainâs blood vessels.
- You should drink ginger tea several times during the day till you get relief. You have to make sure that you drink it when your headache begins.
- Simply, you can chew a piece of fresh ginger root. It will also help in treating your problem and reducing symptoms such as nausea and digestive distress.
Recommended Reading: Cerebellar Migraine
Migraine Prevention Medications: What Is The Best One
First Line Treatment | The List | Anti-Seizure Medications | Tricyclic Antidepressants | SSRIs | Beta Blockers | Calcium Channel Blockers | NSAID’s | Aspirin | Botox | Anti-Nausea | Alternatives
Here’s a list of migraine prevention medications you might consider to help prevent your next attack. The details and common side effects are listed below.
It will be helpful to prepare and educate yourself before and after your doctors appointments with this information, so it doesn’t sound like Latin or Klingon and you get lost in a sea of confusion.
After all… you are learning a new language. And the best one will be the one that works for you…
I sure wish I had the internet as a resource when I was trialing medications to better prepare myself.
Back then I just relied on what my one general family physician said. It was like the word of God!
WOW! That does make me sound old. Well, I am… but I want to highlight the huge amount of available resources and information available to you now.
I urge you to do some research. Read and make sure you know what you are taking before you take it.
Your pharmacist is also a wealth of knowledge, so don’t be afraid to ask questions.
The aim of migraine prevention medications is to lessen the frequency, intensity and duration of the migraine attacks.
In some cases, much lower doses are required than those used to treat the initial common or coexisting disorder.
Which Treatment Option Is Best For You
Keeping a diary of your headaches, including when they occur in relation to your menstrual cycle, as well as their severity and response to treatment, will help your doctor determine the presence of menstrual migraine. There are not any blood tests or any type of imaging that can be done to diagnose this, says Dr. David. Its purely done based on the history.
A headache and menstrual diary can also help you and your doctor identify the best treatment for you. Women with menstrual migraine who have painful cramps may benefit more from a NSAID strategy with a triptan for rescue. Those who have predictable cycles and migraine attacks may benefit from a mini-prevention strategy. Those who dont have regular cycles can try other options.
It is also important to discuss with your doctor any personal risk factors you may have for taking oral contraception, such as an increased risk of stroke, heart disease or blood clots, as hormonal birth control can affect women with migraine differently. Please let your provider know if you have migraine with aura when discussing hormonal options.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
Read Also: Cream Of Tartar Migraine