As any migraine sufferer knows, a migraine headache can be debilitating. There is no one cure-all for a migraine. Every headache is as distinct as its owner. At times, individuals can even fall victim to several types of headaches. First and foremost, it is important to seek medical attention in order to be sure that your headache is indeed a migraine. While there are many types of headaches, some headaches are an indication of more serious medical problems such as strokes or tumors. It is important to actually be diagnosed with migraines prior to starting any type of migraine treatment whether or not it involves medication.

The number one goal of any medical intervention for migraines is to relieve the pain. When a migraine strikes, victims seek immediate relief from the throbbing pain, nausea and vomiting. Sufferers also seek to be relieved of the other symptoms associated with the migraine such as visual aura, and sensitivity to lights, smells and sounds. Generally, there are two types of medical treatments that doctors focus on for migraine relief—prophylactic (prevention of migraine) and symptomatic (for acute attacks). For those who suffer from migraines periodically, doctors may prescribe a medication to provide immediate relief. Sufferers who have migraines frequently may be prescribed preventative medications as well as medication for acute migraines commonly referred to as “breakthrough headaches” because they occur despite use of prophylactic medications.

Not every migraine medication will work for every patient. It is important to weigh the benefits versus the risks. Patients should discuss their concerns before taking a specific medication. For instance, some medications are known to cause weight gain or a decrease in libido. Not everyone is willing to accept risks such as these. Patients should also advise their doctor of all medications they are currently taking—prescription or over-the-counter. Serious interactions could result if this is not discussed. The pharmacist could also be a resource to discuss medication interactions with.

For acute treatments doctors may prescribe analgesics such as aspirin or acetaminophen. Unfortunately, analgesics or “painkillers” rarely work on severe migraines and it may take several doses for any type of relief to occur. If over-the-counter painkillers do not work, doctors may prescribe stronger analgesics that are considered narcotics which can become addicting. Those taking analgesics—over-the-counter or prescribed—should not take them more than two to three times per week because analgesic rebound headaches could occur. Non-steroidal anti-inflammatory drugs (NSAIDS) are also prescribed by doctors instead of aspirin or acetaminophen and they address migraines in much the same way.

Triptans are acute migraine specific medications. Triptans are different than painkillers; they work by constricting blood vessels and lessening the inflammation around the vessels. Unlike the traditional painkillers, triptans also aid in reducing some of the symptoms associated with migraines like nausea. Doctors report that while triptans are expensive they are cost effective.

When it comes to prophylactic treatments for migraines, doctors also suggest some non-medicinal strategies such as avoiding migraine triggers altogether or moving to a cool, dark place if an attack feels imminent. If a migraine is on the verge of occurring or is still in its “mild” state, it is a good idea to lay down (if possible) and apply a cold compress to the side of the head that is affected. Preventative medications are taken consistently, usually on a daily basis, whether the patient has a headache or not. The entire purpose of prophylactic medications is to avoid getting a migraine altogether. While there is no guarantee that migraines will disappear, doctors describe the success of prophylactic treatments as reducing migraines by at least 50%.There are several kinds of prophylactic medications typically prescribed for migraine sufferers.

The most popular are:

• Beta-blockers—Heart/ high blood pressure medications found to work on migraines by preventing the dilation of blood vessels.
• Tricyclic anti-depressants—used to treat depression, these medications have shown to be pain relievers at low doses.
• Anti-seizure medications—Researchers have studied the similarities between migraines and seizures, most notably the fact that both cause the patient to have an aura prior to onset. These medications are effective at treating migraines that present with an aura.

Doctors and researchers are always studying other classes of medications that may have been originally formulated for other medical conditions to determine if they are indicated in the relief of migraines. The use of anti-serotonin medications, calcium channel-blockers and botox injections are just a few of the other treatment options that doctors may prescribe.

No matter what medication is prescribed it is always up to the patient to be the leader on the treatment team. Migraine sufferers need to be consistent in taking medications as prescribed and they need to keep track of triggers, symptoms, and actual headaches. Patients should also discuss with their doctors alternative treatments to medication such as relaxation techniques and overall stress management. In the end, medications will only be as effective as the diligent patient who takes charge of her care.