Treatment and Prevention

Over the years, there have been several methods of treatment developed to address the symptoms of migraines, as well as the body's response to the triggers that cause migraines to occur. Until recently, there has not been any single treatment or therapy that worked well across a broad population of patients.

Today, emerging breakthroughs in neuroscience are providing entirely new and innovative therapies for Migraine sufferers. One such breakthrough is the result of years of clinical research by Dr. William Collins, PhD. Dr. Collins' research has produced new, safer treatment options that not only provide treatment of acute attacks, but that also help prevent future attacks. No longer is a person's "pre-disposition" for migraine a lifetime sentence of illness.

Listed below are additional modalities of therapy that are currently being used to treat migraines, and the side effects of each.

Non-medication therapies for migraine

Therapy that does not involve medications historically only provided symptomatic relief and limited preventative therapy. Using ice, massage, acupuncture and relaxation techniques have been of limited help at stopping an attack once it has started. For most, sleep has been the best medicine. This is because sleep has provided a way to "wait out the storm" and allow the brain to re-integrate itself after an episode.

Preventing migraine headaches is no easy task. It historically took a great deal of motivation for the patient to make some life changes, and those changes did not always produce the desired outcome. Patients can learn their triggering factors so that triggering events can be avoided. These include smoking cessation, avoiding certain foods especially those high in tyramine (sharp cheeses) or those containing sulphites (wines) or nitrates (nuts, processed meats). Generally, leading a healthy life style with good nutrition, adequate water intake, sufficient sleep and exercise can be helpful, but not curative.

Medication therapies for migraine

Individuals with occasional mild migraine headaches that do not interfere with daily activities usually medicate themselves with over-the-counter (OTC, non-prescription) pain relievers (analgesics). Many OTC analgesics are available. OTC analgesics have been shown to be safe and effective for short-term relief of headache (as well as muscle aches, pains, menstrual cramps , and fever) when used according to the instructions on their labels.

There are two major classes of OTC analgesics: acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). The two types of NSAIDs are aspirin and non-aspirin. Some NSAIDs are available by prescription only. Prescription NSAIDs are usually prescribed to treat arthritis and other inflammatory conditions such as bursitis, tendonitis, etc. The difference between OTC and prescription NSAIDs may only be the amount of the active ingredient contained in each pill.
Acetaminophen reduces pain and fever by acting on pain centers in the brain. Acetaminophen is well tolerated and generally is considered easier on the stomach than NSAIDs. However, acetaminophen can cause severe liver damage in high (toxic) doses or if used on a regular basis over extended periods of time. In individuals who regularly consume moderate or large amounts of alcohol, acetaminophen can cause serious damage to the liver in lower doses that usually are not toxic. Acetaminophen also can damage the kidneys when taken in large doses.

NSAIDs relieve pain by reducing the inflammation that causes the pain (They are called non-steroidal anti-inflammatory drugs or NSAIDs because they are different from corticosteroids such as prednisone, prednisolone, and cortisone which also reduce inflammation). Corticosteroids, though valuable in reducing inflammation, have predictable and potentially serious side effects, especially when used long-term. NSAIDs do not have the same side effects that corticosteroids have.

The main difference between aspirin and non-aspirin NSAIDs is their effect on platelets. Platelets are small particles in the blood that cause blood clots to form. Aspirin prevents the platelets from forming blood clots. Therefore, aspirin can increase bleeding by preventing blood from clotting though it also can be used therapeutically to prevent clots from causing heart attacks and strokes. The non-aspirin NSAIDs also have anti-platelet effects, but their anti-platelet action does not last as long as aspirin. Aspirin, acetaminophen, and caffeine also are available combined in OTC analgesics for the treatment of headaches.

Finding an effective analgesic or analgesic combination often is a process of trial and error because individuals respond differently to different analgesics. What other medications are used for treating migraine headaches? Narcotics and butalbital-containing medications sometimes are used to treat migraine headaches; however, these medications are potentially addicting and are not used as initial treatment. They are sometimes used for patients whose headaches fail to respond to OTC medications but who are not candidates for triptans either due to pregnancy or the risk of heart attack and stroke.

How are migraine headaches prevented?

Historically there have been two primary ways to prevent migraine headaches: 1) by avoiding factors ("triggers") that cause the headaches, and 2) by preventing headaches with medications (prophylactic medications). Neither of these preventive strategies have been 100% effective, and the best one can hope for is to reduce the frequency of headaches.

New research into the epidemiology of migraine headaches, and how the brains desire to compensate for functional imbalance have lead to new treatments that can safely reduce the symptoms, frequency and severity of migraine headaches. We are constantly reviewing literature, new options and avenues to assist migraineurs with their problems. For more information, contact the Migraine Relief Institute at 314-966-4900.