There Are Many Different Types Of Medications That Can Prevent And Treat Migraines, And There Probably Is A Combination That Will Give You Relief
If you suffer from migraines, you will know that they are able to disrupt your day-to-day life. This is a chronic, recurrent, and often debilitating nervous system condition that most often causes headaches, but also causes nausea, vomiting, restlessness, vision changes and even depression.
It is estimated that 13 per cent of Canadians experience migraines. More women than men are affected, with about 18 per cent of women and six per cent of men. (This difference in incidence points to female hormones being involved in some manner.) Migraines also affect younger people, most often between 25 and 55 years of age, and the condition does have a family tendency.
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Unfortunately, there is no one clear cause for migraines. Rather there may be a combination of effects that makes you susceptible.
Both the nervous system — specifically, the brain, and blood vessels found in the brain, seem to be involved. Changes in neurochemicals within the nervous system cause cortical spreading depression or CSD, which in turn activates other areas of the brain. Like a pebble dropped into a pool of water, the initial changes ripple through the brain, causing blood vessel dilation, nervous system inflammation, and headache pain.
It is thought that people susceptible to migraines have a lower threshold for these effects, especially when exposed to outside stimuli or trigger factors.
The changes can occur over hours or days, and some migraine sufferers can sense that the changes are occurring. For some people “catching the migraine right away” can actually reduce the symptoms.
An aura, which occurs in 10 to 20 per cent of people, usually precedes the migraine by no more than an hour. Visual changes, flashing lights, intensified or changed hearing, and even difficulty speaking are characteristic of an aura. Again, speedy treatment will reduce symptoms.
Because a migraine is a headache, pain relievers are often used to treat the symptoms of a migraine. However, they should be used sparingly. Rebound headache and incomplete pain relief are drawbacks. For mild to moderate headache symptoms, the best are non-steroidal antiinflammatories, such as ibuprofen.
The newest group of drugs are the 5-HT receptor agonists which are able to block inflammation and blood vessel dilation, thereby stopping the headache. Examples include naratriptan, rizatriptan, sumatriptan, and zolmitriptan. (You can see why the group is called the “triptans.”)
Preventing migraines is preferred to treating them. Propranolol and timolol are beta blockers more often used in heart conditions, but they are able to keep blood vessels in check, preventing inflammation and dilation.
Medications used for seizures, for example topiramate and divalproex, stabilize the nervous system and prevent the cascade of events that leads to migraines. Amitriptyline is an antidepressant, but it can also affect the nervous system, reducing the incidence and severity of migraines.
Often these preventers were discovered by accident when a sufferer would be take the drug for another condition and notice that they had fewer migraines.
Many people dismiss migraines as “only headaches” and others have experienced poor results with drug treatment. Thus migraines tend to be under-diagnosed and undertreated. If you do experience headaches and think they may be migraines, have them evaluated. At the very least this will eliminate other causes of the headache symptom.
Also keep a headache diary. Make a note of any headaches you may have and what you were doing, as well as what you were eating. You may be able to identify a trigger which you can then avoid.
Remember, there are many different types of medications that can prevent and treat migraines, and there probably is a combination that will give you relief.
Marie Berry is a lawyer/pharmacist interested in healthcare and education
