Headache Headache Treatment

Medicine for Your Migraine

Migraine headaches cause severe pain and tremendous disability, and yet less than half of all people who suffer from these disabling headaches are receiving appropriate treatment. Only about fifty percent of the more than thirty million people with migraine have been diagnosed by a physician, and can therefore get the powerful prescription medications that can stop migraines in their tracks.

How does a migraine behave?
Migraine often manifests as a one-sided, severe, throbbing headache in or behind the eye, and occurs in women three times more often than men. It is associated with nausea, vomiting, and sensitivity to light and sound, and is sometimes preceded by a visual aura, such as multicolored dots or bright zigzag lines, which might obscure vision for about twenty minutes. If left untreated, the entire migraine attack can last from twenty-four to forty-eight hours and is often associated with disability, preventing the patient from working, going to school, or taking care of domestic tasks.

Triptans
Triptans are the most powerful class of drugs available to stop migraine. This type of medication shrinks the dilated blood vessels and decreases the inflammation, which affects the meninges, or covering of the brain during the migraine attack.

There are five triptans available in the U.S. The first triptan became available in 1993, when sumatriptan was launched as a self-injectable shot. It is now available to people in the form of nasal sprays and tablets. The second triptan released was zolmitriptan, which was launched as a tablet three years ago. In March it became available as an orange flavored melt tablet called Zomig ZMT, which dissolves on the tongue in thirty seconds. Zomig ZMT can begin to work in thirty minutes and brings sixty-four percent of patients' migraines under control in two hours with minimal side effects.

Other similar medications now available are naratriptan (as a tablet) rizatriptan (as a tablet and melt tablet) and almotriptan (which was recently approved as a tablet).

Although all triptans are safe and effective, they can narrow blood vessels, so they cannot be given to patients with heart disease, blood vessel problems, or high blood pressure, and they must be used very cautiously in any patient with cardiac risk factors, or hidden signs of heart disease.

Preventive medication
Some migraine sufferers may require preventive medication. Those with two or more migraines per week, those who cannot tolerate triptans for some reason, and sufferers who experience severe disability, can be placed on daily, preventive medications. Preventive medications include beta-blockers and calcium blockers- usually used for blood pressure and cardiac problems - or they can try antidepressants or anti-epilepsy drugs. Sometimes, large doses of magnesium and vitamin B2 can be helpful when taken on a daily basis for at least three months. Relaxation and biofeedback training, and other behavioral medicine techniques can also be helpful in reducing the frequency and intensity of the headaches.

Effective medication still to come
Two other triptans are expected to be released in 2001, and researchers are investigating new forms of acute and preventive medications for migraine. Last, but certainly not least, in order for people to be treated properly, it's important that they go to the doctor and receive a proper diagnosis.