Migraine treatment

 

Migraine treatment

Treatment of migraine, migraine or fissures is mainly aimed at eliminating the symptoms of migraine attacks and reducing the chance of other attacks in the future, and the affected person may need to try several types of available treatments so that he can know the appropriate treatment for him, and in general, choose the treatment The most appropriate migraine headache depends on the severity of the headache, its frequency, its impact on the patient's ability to carry out his or her daily activities, and how closely they relate to it.  For the occurrence of symptoms such as nausea and vomiting, and whether the patient suffers from other health problems, and in this context it must be clarified that these drug treatments are divided into two main types, which can be clarified as follows:

•  Anti-seizure medications: These are pain relievers that are taken during a migraine attack in order to relieve or stop the symptoms, in addition to other medicines that relieve the symptoms associated with the attack. 

• Preventive medications: These are taken regularly to reduce the severity of migraine attacks and reduce their frequency.

seizure medications

The goal of using epilepsy medication is to stop a migraine attack as soon as it starts. Therefore, the best time to take these medications is right after the symptoms of a migraine attack start or when you feel them approaching, and the most important groups of medications that are included in the pain list are listed below: Migraine medications, either prescription or over-the-counter. 

 Analgesics

Many over-the-counter pain relievers can be used to relieve migraine symptoms, including acetaminophen and some nonsteroidal pain relievers, such as ibuprofen and aspirin.  With regular tablets and suppositories that can be used in case of a migraine attack accompanied by nausea and vomiting, highlighting the importance of following the instructions attached to the medication regarding recommended doses and duration of use.  Taking pain relievers continuously can exacerbate migraine symptoms and cause what are known as rebound headaches.

 Sometimes the doctor may resort to the prescription of opioid analgesics, for example: Codeine, which is characterized by its ability to block the formation of pain signals in the brain and spinal cord, in case of severe pain and insufficient regular analgesics , but you should pay attention.  You pay for using these types of pain relievers by the possibility of addiction, which is a habit, the body becomes dependent on the drug as a result of using it for a long time, which causes side effects to appear when the drug is stopped suddenly .  It is known for drug withdrawal symptoms such as diarrhea and nausea.

 triptans

 Your doctor may prescribe a triptan if pain relievers, especially over-the-counter pain relievers, fail to relieve your migraine pain. In addition to this group's ability to relieve headaches, it can help relieve nausea, vomiting, sensitivity to light and sound, and triptans are available in different dosage forms; Oral tablets, nasal sprays, and injections such as sumatriptan and naratriptan.  In fact, the doctor depends on the choice between the symptoms of the headache and the duration of the headache attack. In fact, it is believed that the principle of action of triptans is based on reversing the changes that cause migraines in the brain. For example, triptans cause constriction of blood vessels in the brain, which have become widened due to migraines.

 antiemetics

Antiemetics can be used to treat migraines with aura associated with nausea and vomiting, but can also be effective in treating migraines even if these symptoms are not present.  Your doctor usually prescribes these medications along with pain relievers or triptans. Antiemetics such as metoclopramide and domperidone have been found to contribute to the acceleration of bowel movement and thus the absorption of analgesics.

 dihydroergotamine

 Dihydroergotamine is used to treat migraine attacks after they have started. Therefore, taking dihydroergotamine even two hours after the headache started may be effective in controlling the headache. This medicine is available in several pharmaceutical forms. Nasal and intravenous capsaicin injections, which are recommended for use with chronic or difficult-to-treat migraines, and should not be used by people with high blood pressure or uncontrolled heart disease.  Just as for a pregnant woman, it is not a wish.

combination drugs

 Combination medicines contain more than one active ingredient in the same tablet. The drug may combine a pain reliever with an anti-nausea drug or a triptan. In fact, some patients find that taking combination medications is the most suitable option for them. An example of a combination drug available in pharmacies is one that contains acetaminophen, aspirin, and caffeine, which is considered safe. It can be bought without a prescription, and here it is stated that caffeine may play a role in improving the body's absorption of painkillers, leading to better treatment results, but continuing to take this medication may be accompanied by pain headache after stopping it, and the reason for this is due to the caffeine. 

 preventive medications

 It is used to treat frequent, chronic, or severe migraines that do not respond well to previous treatments. Because it helps reduce the frequency, severity, and duration of migraine attacks, your doctor may prescribe any of the preventive medications if you have four or more migraine attacks per month.  Preventive drugs include the following groups of drugs:

Medications to lower blood pressure

 The doctor may prescribe antihypertensive drugs, specifically some drugs belonging to the group of beta-blockers and calcium channel blockers. As a preventive treatment for migraine with aura, like beta-blockers, an example of this is propranolol, which helps reduce the activity of brain cells involved in the onset of migraines, but it should be noted that it is not.  Suitable for some patients, such as those with asthma or chronic obstructive pulmonary disease. Calcium channel blockers, such as flunarizine, prevent calcium from entering brain cells, making them less sensitive to migraine attacks, and block dopamine receptors in the brain. 

 Tricyclic antidepressants

 It is known that tricyclic antidepressants were used -especially in the past- in the treatment of depression, but the doctor can prescribe these drugs as a preventive treatment of migraine, especially in cases of migraine accompanied by sleep disorders, since it is Tricyclic antidepressants Antidepressants are believed to prevent the reuptake of serotonin and norepinephrine and may block serotonin receptors.  Medications in this group include amitriptyline, and because it can cause drowsiness, it is recommended to take it at bedtime. It should be noted that the patient may feel the desired benefit of amitriptyline after six weeks of daily compliance.

anticonvulsants

A doctor may prescribe anticonvulsants or antiepileptics as preventive treatment for migraines. Because it helps reduce the frequency of migraine attacks, like valproate and topiramate, and with respect to the latter, it has been widely used to treat migraines. It should be noted that topiramate can harm the fetus if used by a pregnant woman . . Women can already reduce the effectiveness of hormonal contraceptives, and to solve this problem, the doctor can resort to replacing the contraceptive method with another that is not affected by topiramate. 

 Other treatments

 Other preventive treatments that can be used for migraines include:

 Botulinum toxin A, or Botox, is used in small doses to treat many problems, including chronic migraines that have not responded to at least three other preventive treatments.  12 months, but the doctor can give Botox injections again after three months. In fact, it is still not clear why Botox injections are effective in treating migraines, but in general, the principle behind Botox injections is to weaken or paralyze certain muscles.  It should be noted that Botox is not suitable for pregnant or lactating women, and the most common side effects of these injections are: sensation of pain, swelling or bruising at the injection site. 

peptide antibodie:sIt is one of the preventive therapies developed for the treatment of migraine, and its principle of action is based on the inhibition of peptide activity.  This peptide plays a role in the occurrence of pain and brain aneurysm, and antibodies are divided into four types of compounds; Three of these are designed for subcutaneous injection once a month, and the fourth, known as ibtanizumab, is designed for intravenous injection once every 3 months.

Menstrual-related migraine treatment

Menstrual-related migraines typically start two days before your period and last up to three days after, and because they're easy to predict, they can be prevented with hormonal and non-hormonal treatments. 

  Non-hormonal treatment: Your doctor may prescribe non-steroidal pain relievers and triptans to control menstrual migraines, you can start taking them two days before or right after your period and continue taking them until the last day of your period. . 

  Hormonal treatments: in which the doctor may prescribe combined contraceptives (containing estrogen and progesterone) or progesterone-only contraceptives, or estrogen-only contraceptives, whether they are oral tablets, or patches, or injections and other pharmaceutical forms, and it should be noted that hormonal treatments are not suitable for women suffering from migraine with aura; This is because it increases the risk of serious health

Migraine treatment for pregnant women

The stage of pregnancy is very delicate and care must be taken to choose the optimal treatment without harming the fetus. In fact, avoiding migraine triggers is also the best option at this time, and if drug therapy is necessary, your doctor may prescribe acetaminophen in reduced doses. This did not work, the doctor may resort to prescribing sumatriptan or ibuprofen, which pregnant women use intermittently, in this context, it is indicated that the doctor takes into account the stage of pregnancy before choosing a drug treatment; For example, taking ibuprofen during the first and last trimester of pregnancy carries some risks, so the doctor may prescribe it conservatively and under certain conditions.  As for preventive treatments during pregnancy, many times the doctor does not resort to prescribing them except in severe cases. cases. Although migraines gradually improve during pregnancy, symptoms return soon after delivery, and pregnant women with migraines should see a doctor and get enough information to ensure a safe pregnancy and delivery.

Tips to relieve migraine symptoms

The best thing to do when a migraine attack starts is to go to a quiet, dark room and try to relax or take a nap, especially if the attack is accompanied by an aura. An ice cube wrapped in a cloth can be placed on the forehead or the back of the neck to relieve migraine symptoms On the other hand, knowing the triggers and avoiding them is an early preventive treatment that can be followed to prevent migraine attacks or limit their development as much as Arrange waking, sleeping, and eating times and make sure they are adhered to.

•  Drink plenty of fluids, especially water, to avoid dehydration.

•  Have a migraine attack notebook, in which the causes of headaches can be identified and the treatments used are the most effective.

• get regular exercise, such as aerobic exercise; Such as walking, swimming and cycling due to their role in reducing stress and excess weight, and the need to warm up before starting exercise should be taken into account, as exercise can suddenly trigger a migraine attack .