Migraine lasts many years. The nature and course of migraine is so diverse that approaches to treatment should be strictly individual. Often means helping one person, be useless for another. A consultation is required for selecting the most effective treatment.
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Migraine is among the health conditions that are particularly difficult to foresee the results of treatment.
The main principles of treatment:
- individual approach;
- patience from both the patient and the doctor. The selected method of treatment it is important to follow consistently and not to rush to replace it after a few days if he will not be effective;
- Know that in the treatment of migraine is important not only drugs but also the accompanying lifestyle, the elimination of the factors provoking attacks, psychotherapy, autogenic training.
In the treatment of migraine using a large list of medications: analgesics, sedatives, tranquilizers, antidepressants, antiemetics, derivatives of ergotamine, calcium channel blockers, nonsteroidal anti-inflammatory drugs, agonists and antagonists of serotonin.
The therapeutic course includes treatment of the attack and treatment, for prophylaxis, in the interictal period. It is important that the necessary range of drugs in the acute phase and for prophylaxis was determined by the specialist.
- Identify precipitating factors that can be eliminated: Smoking, alcohol intake, lack of sleep, stress, overwork, eating certain foods, particularly chocolate and cheese that contains tyramine. Sometimes an attack is triggered by vasodilators (e.g., nitroglycerin or dipyridamole).
- When depression and anxiety is a psychotherapy and drug therapy.
- Medications must be taken already at the first harbingers of the attack. In mild cases, prescribed aspirin, 650 mg orally as a single dose, or paracetamol, 650 mg orally once.
- Prior to the termination of attack is recommended to lie better in a dark, cool, quiet room.
- Recommend cold on your forehead or neck.
- Some people need a tight headband.
- If severe nausea can provoke vomiting (“restaurant method”). This can stop the seizure.
- During the attack you can not drink coffee, tea, orange juice.
- If it helps the patient sleep, then additionally prescribe hypnotics: temazepam, 10 mg single oral dose, or diazepam, 10 mg orally once.
- About a third of women suffering from migraine, oral contraceptives increase the frequency of attacks, so appropriate trial cancel of these funds. On the other hand, sometimes their admission improves the condition.
Treatment of migraine attack start as soon as possible:
- In the classical migraine is the appearance of prodromal symptoms.
- With a simple migraine – headache since the beginning.
Sometimes the attack is limited to prodromal phenomena, and therefore some experts recommend always to begin treatment only if symptoms like headaches. For relief of migraine attacks can be assigned to non-specific (analgesics, NSAIDs) and specific (ergotamine, dihydroergotamine, sumatriptan) funds. Typical representatives of the first group are paracetamol and acetylsalicylic acid (aspirin). In recent years for the treatment of migraine began to apply triptana (serotonin agonists). Sumatriptan (Imigran), released in 1993 and is still the most used. For imigrana in followed zomig, amerge and maxalt; coming soon. New triptana work effectively, just like imitrex, but each has its advantages: one quickly reaches the brain, the other longer (Although all triptana excreted in a few hours, a migraine and sometimes returned). Some patients use more than one drug – say, imitrex especially for unbearable migraines and zomig for one that simply prevents to work. A comprehensive study of effective migraine meds, especially triptanov – imitrex and zomiga, is not yet complete, but some results show that these drugs are equally effective for children as for adults.
Preventive therapy is not prescribed during pregnancy or planned pregnancy. In the selection of drugs should consult a doctor.
Used beta-blockers (propranolol), tricyclic antidepressants (amitriptyline), antiserotoninergic and nonsteroidal anti-inflammatory drugs(naproxen, diclofenac). Information about the effectiveness of prophylactic anticonvulsants (drugs carbamazepine, valproic acid), ergot alkaloids (ergotamine, dihydroergotamine) and calcium antagonists is not enough. Treatment usually starts with beta-blockers or tricyclic antidepressants. Be careful with pain relievers. There is no worse medicine for headache than regular use of painkillers. Systematic use of these drugs leads to lowering of pain threshold and an increase in the frequency of headache attacks. If you have to resort to overly high doses of pain medications, contact your doctor, so he picked up a personal treatment program for headaches.