Treatment Of Headache
Prescribed Medication For Migraine Relief
New therapies to treat headache go back to the
beginning of the last century when ergotamine tartrate was first
isolated in a laboratory. It was this development which introduced
clinical practice into treating migraines. Ergotamine works by
constricting blood vessels in the head. About twenty-five years later
researchers began to suspect that disturbances in the brain’s serotonin
level played a role in migraine. The drug, methysergide, a serotonin
antagonist that prevents migraine attacks, was introduced into clinical
practice in 1958. In recent years, new technologies have made it
possible for researchers to identify serotonin receptors throughout the
body. It is now believed that serotonin levels actually decrease at the
onset of a migraine attack, causing blood vessels to dilate and
surrounding tissues to swell. This is that brings on the pain.
Studies show that stimulating certain subtypes of serotonin
receptors constrict blood vessels in the head, thereby eliminating an
acute migraine attack. Ergotamine and DHE can also cause nausea and
vomiting because they stimulate dopamine receptors. This research has
led to the development of the new triton drugs that switch on
appropriate serotonin receptors, providing effective migraine relief
without many of the side effects of earlier drugs.
Examples of medications currently on the market used to prevent migraines
include: propranolol (brand name: Inderal), timolol (brand name: Blocadren),
divalproex (brand name: Depakote) and some antidepressants.
Symptomatic relief medications are used, as their description suggests, in the
relief of the actual symptoms that are most commonly associated with
migraines. These include head pain, nausea and vomiting.
Abortive medications are used at the first sign of a migraine in an attempt to
halt the process that causes the headache pain. Abortive medications
work by constricting the blood vessels, bringing them back to normal and
relieving the throbbing pain.
Preventive (prophylactic) medications are prescribed for severe headaches that
occur more than twice a month, and that significantly interfere with daily activities.
Preventive medications are intended to reduce both the frequency and the
severity of the headache and are usually taken daily. A medicine called
ergotamine (Ergostat) has been effective both when used by itself and
when used in combination with other medicines. Dihydroergotamine
(Migranal, D.H.E. 45) is related to ergotamine and has also found to be
effective.
Other prescription medicines for migraines include
sumatriptan (brand name: Imitrex)
zolmitriptan (brand name: Zomig)
naratriptan (brand name: Amerge)
rizatriptan (brand name: Maxalt)
almotriptan (brand name: Axert)
eletriptan (brand name: Relpax)
frovatriptan (brand name: Frova)
If after taking any of these medications you still suffer migraine pain, then
an even stronger medicine may be recommended. These ultrastrength migraine
medications include a narcotic (brand name: Stadol nasal spray) and medicines
that contain a barbiturate. Before moving on to this hard stuff, however, be
aware that these medications are often habit-forming and should be used with
extreme caution and only as absolutely needed. As with any medication,
it is important to carefully follow the label instructions and your
physician’s advice.
The effectiveness of migraine treatment depends on a variety of factor.
It’s very important to determine what your migraine trigger is. How
successful you are in avoiding your, how proactive your are in administering
your treatment, the patient is in using treatments such as relaxation or drugs
and how well the patient responds to treatment.
The seven triptans include sumatriptan (Imitrex), zolmitriptan (Zomig), and
naratriptan (Amerge). Unlike traditional migraine medications, which help the
body tolerate headache pain, triptans help manage the source of migraine pain
by reducing "swelling" of the blood vessels in the brain and reducing
inflammation, thus helping alleviate migraine pain.
Triptans are not recommended, however, for ocular migraines, because the constricting
affect they have on blood vessels could cause problems in the retinal
vessels, resulting in vision loss. The best treatment for ocular
migraine, says Dr. Mays, is prevention—avoiding triggers, minimizing
stress, maintaining a consistent schedule and getting enough sleep.
Treating migraines with prescriptive medication can be very effective, but don’t
count on it. Many do find relief through the newer medications on the
market, but there are plenty who suffer through the trial period without
any gain in the end. You may have to try out several medications before
you come across the one that finally ends your misery.