Migraine is a severe, throbbing headache on one side of the head that is often accompanied by nausea and the inability to tolerate light and noise. Migraines are often preceded by auras, which can include tunnel vision, flashing lights or specks of light. The length of a migraine can vary from a few hours to several days. Drugs are used to reduce the length and severity of migraines or to prevent them from occurring.
Triptans
The triptans are also known as serotonin agonists and are the most widely prescribed drugs for migraine. They imitate the actions of serotonin in the central nervous system. Serotonin prevents the dilation of the blood vessels and the release of other substances that cause vasodilation and irritate nerve endings in the brain.
The effects of triptans usually wear off before the migraine is gone, so patients may have to repeat doses during a migraine attack. People with heart conditions should not take triptans.
Side effects of triptans include tingling sensations, dizziness, weakness and neck pain. One to five percent of people taking triptans experience chest pain. Since chest pain could indicate something serious, people with migraines should always seek medical attention for chest pain.
Triptans include sumatriptan (Imitrex), almotriptain (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt) and Zolmitriptan (Zomig).
Ergot Alkaloids
Ergot alkaloids are serotonin agonists. This means that they stimulate areas usually stimulated by serotonin. Ergot alkaloids are most effective if they are given at the first symptoms of migraine. These drugs are specific for migraine pain, and they are usually not helpful for other kinds of pain. Ergotamine, the ergot alkaloid sold as Cafergot, contains caffeine to help the body better absorb it.
Anti-Seizure Drugs
Anti-seizure drugs help with migraines by reducing the excessive firing at the nerve endings. Topiramate (Topamax) and valproic acid have been approved for migraine prevention. The side effects include drowsiness, dizziness and nervousness.
Beta Blockers and Calcium Channel Blockers
Beta blockers and calcium channel blockers are drugs used to treat high blood pressure and other heart problems, but they are sometimes used off-label for migraine prevention. Experts believe these drugs prevent migraines by preventing the blood vessels in the head from dilating too much. The most common side effects are dizziness and low blood pressure.
Antidepressants
Tricyclic antidepressants and selective serotonin reuptake inhibitors prevent migraine headaches. Their actions are similar to that of the triptans, but instead of mimicking the action of serotonin, they keep more serotonin circulating in the central nervous system.
References
- Basic and Clinical Pharmacology; Bertram Katzung; 2007
- U.S. Pharmacist; Migraine: Its Recognition and Treatment
- Merck Medicus on Migraines
