Migraine Treatment
There are two clinical approaches to treating migraines – abortive treatment and preventive treatment.
Abortive migraine treatment
This is sometimes referred to as acute treatment or pain-relieving treatment. The goal of abortive migraine treatment is to prevent a migraine attack or to stop it once it starts.
The medication perscribed can stop a headache during its prodrome stage or once it has begun and may be taken as needed.
Some abortive migraine treatments are administered as a self-injection into the thigh. Others can be taken as a wafer that melts on the tongue.
These forms of medication are especially useful for people who vomit during a migraine, and they work quickly.
Abortive treatment medications include the triptans, which specifically target serotonin.
They are all very similar in their action and chemical structure.
The triptans are used only to treat headache pain and do not relieve pain from back problems, arthritis, menstruation, or other conditions.
- Sumatriptan (Imitrex)
- Zolmitriptan (Zomig)
- Eletriptan (Relpax)
- Naratriptan (Amerge, Naramig)
- Rizatriptan (Maxalt)
- Frovatriptan (Frova)
- Almotriptan (Axert)
The following drugs are also specific and affect serotonin, but they affect other brain chemicals.
Occasionally, one of these drugs works when a triptan does not.
- Ergotamine tartrate (Cafergot)
- Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray)
- Acetaminophen-isometheptene-dichloralphenazone (Midrin)
- Ergotamine tartrate (Cafergot)
- Dihydroergotamine (D.H.E. 45 Injection, Migranal Nasal Spray)
- Acetaminophen-isometheptene-dichloralphenazone (Midrin)
The following drugs are mainly used for nausea, but they sometimes have an abortive or preventive effect on headaches:
- Prochlorperazine (Compazine)
- Promethazine (Phenergan)
The next drugs are weak members of the narcotic class. They are not specific for migraine, but they can help relieve almost any kind of pain. Since they are habit forming, they are less desirable than the specific headache drugs listed above. These drugs should be used primarily as a “backup” for the occasions when a specific drug does not work.
- Butalbital compound (Fioricet, Fiorinal)
- Acetaminophen and codeine (Tylenol With Codeine)
Preventive migraine treatment
This type of treatment is considered if a migraineur has more than 1 migraine per week. The goal is to lessen the frequency and severity of the migraine attacks. Medication to prevent a migraine can be taken daily. Preventive treatment medications include the following:
- Medications used to treat high blood pressure – Beta-blockers (propranolol [Inderal]), calcium channel blockers (verapamil [Covera])
- Antidepressants – Amitriptyline (Elavil), nortriptyline (Pamelor)
- Antiseizure medications – Gabapentin (Neurontin), valproic acid (Depakote), topiramate (Topamax)
- Some antihistamines and anti-allergy drugs, including diphenhydramine (Benadryl) and cyproheptadine (Periactin)
Source
Some of the information on this page was taken from WebMD Medical Reference from eMedicineHealth, reviewed by Jonathan L Gelfand, MD on January 23, 2008 © 2007 WebMD, Inc. All rights reserved.
