New therapies to treat headache go back to the beginning of the last century when ergotamine tartrate was first isolated in a laboratory. It was this development which introduced clinical practice into treating migraines. Ergotamine works by constricting blood vessels in the head. About twenty-five years later researchers began to suspect that disturbances in the brains serotonin level played a role in migraine. The drug, methysergide, a serotonin antagonist that prevents migraine attacks, was introduced into clinical practice in 1958. In recent years, new technologies have made it possible for researchers to identify serotonin receptors throughout the body. It is now believed that serotonin levels actually decrease at the onset of a migraine attack, causing blood vessels to dilate and surrounding tissues to swell. This is that brings on the pain.
Studies show that stimulating certain subtypes of serotonin receptors constrict blood vessels in the head, thereby eliminating an acute migraine attack. Ergotamine and DHE can also cause nausea and vomiting because they stimulate dopamine receptors. This research has led to the development of the new triton drugs that switch on appropriate serotonin receptors, providing effective migraine relief without many of the side effects of earlier drugs.
Examples of medications currently on the market used to prevent migraines include: propranolol (brand name: Inderal), timolol (brand name: Blocadren), divalproex (brand name: Depakote) and some antidepressants.
Symptomatic relief medications are used, as their description suggests, in the relief of the actual symptoms that are most commonly associated with migraines. These include head pain, nausea and vomiting.
Abortive medications are used at the first sign of a migraine in an attempt to halt the process that causes the headache pain. Abortive medications work by constricting the blood vessels, bringing them back to normal and relieving the throbbing pain.
Preventive (prophylactic) medications are prescribed for severe headaches that occur more than twice a month, and that significantly interfere with daily activities. Preventive medications are intended to reduce both the frequency and the severity of the headache and are usually taken daily. A medicine called ergotamine (Ergostat) has been effective both when used by itself and when used in combination with other medicines. Dihydroergotamine (Migranal, D.H.E. 45) is related to ergotamine and has also found to be effective.
Other prescription medicines for migraines include
- sumatriptan (brand name: Imitrex)
zolmitriptan (brand name: Zomig)
naratriptan (brand name: Amerge)
rizatriptan (brand name: Maxalt)
almotriptan (brand name: Axert)
eletriptan (brand name: Relpax)
frovatriptan (brand name: Frova)
If after taking any of these medications you still suffer migraine pain, then an even stronger medicine may be recommended. These ultrastrength migraine medications include a narcotic (brand name: Stadol nasal spray) and medicines that contain a barbituate. Before moving on to this hard stuff, however, be aware that these medications are often habit-forming and should be used with extreme caution and only as absolutely needed. As with any medication, it is important to carefully follow the label instructions and your physicians advice.
The effectiveness of migraine treatment depends on a variety of factor. Its very important to determine what your migraine trigger is. How successful you are in avoiding your, how proactive your are in administering your treatment, the patient is in using treatments such as relaxation or drugs and how well the patient responds to treatment.
The seven triptans include sumatriptan (Imitrex), zolmitriptan (Zomig), and naratriptan (Amerge). Unlike traditional migraine medications, which help the body tolerate headache pain, triptans help manage the source of migraine pain by reducing “swelling” of the blood vessels in the brain and reducing inflammation, thus helping alleviate migraine pain.
Triptans are not recommended, however, for ocular migraines, because the constricting affect they have on blood vessels could cause problems in the retinal vessels, resulting in vision loss. The best treatment for ocular migraine, says Dr. Mays, is preventionÃ¢â‚¬â€avoiding triggers, minimizing stress, maintaining a consistent schedule and getting enough sleep.
Treating migraines with prescriptive medication can be very effective, but dont count on it. Many do find relief through the newer medications on the market, but there are plenty who suffer through the trial period without any gain in the end. You may have to try out several medications before you come across the one that finally ends your misery.