A migraine is more than just a headache - it is a chronic illness and almost 28 million people suffer from it. Recent research into what works to prevent and control migraine headaches has lessened the suffering for the millions in need of assistance. General guidelines are to choose medications with minimal side effects that are most effective in treating your migraine, and to take an effective medication at the first sign of migraine pain. One approach is to take a migraine "rescue" medicine if non-prescription medications, such as non-steroidal anti-inflammatory agents (NSAIDS) are not effective within 1-2 hours. A migraine rescue medicine is a drug specifically prescribed for relief of migraine headache. However, many migraine sufferers know that they can reliably obtain pain relief only if they go directly to an anti-migraine medication.
Ergotamine and its derivatives have been used to treat migraine headaches for years; however, there are concerns about toxicity. FDA officials have approved 10 new drugs for migraine treatment in the last decade and others are working their way through the necessary studies for approval. The gold standard drugs reside within the triptan family. Researchers have used the triptans (such as sumatriptan and zolmitriptan) as a foundation for an array of variations. One major pharmaceutical company is seeking FDA approval for a combination of sumatriptan and naproxen sodium, an NSAID better known to most of us by one of its copyrighted names, Aleve. Sumatriptan is now known to be most effective if delivered by injection or as a nasal preparation. You owe it to yourself to become as educated as possible about treatment options and to have a good working relationship with your doctor. Not every migraine is the same. People respond in different ways to medications. For instance, one must be aware of "rebound headaches" - headaches that occur in response to taking pain medication to relieve the primary migraine.
Opiates and anti-nausea medications may be necessary to provide relief when other medications are ineffective. Medications used to prevent migraines include beta-blockers, topiramate and other anti-seizure drugs, and antidepressants. Additional medications and treatments are under review for treatment and prevention. One substance that has not yet been approved by the U.S. Food and Drug Administration for migraine treatment is botulinum toxin (Botox). We all know that its cosmetic applications have made it quite popular, but there may be further medical indications for its use, such as migraine headache. Researchers are experimenting with injections of Botox into the scalp muscles. Some doctors are using it "off label" for patients who have not responded to other headache medications, but in such circumstances, insurance companies may not pay for it.
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