A migraine is not just a headache but, rather, a chronic and often-disabling condition characterized by intense, throbbing head pain associated with nausea, vomiting and sensitivity to light and sound that results in nearly $13 billion in lost wages and impaired work performance each year, according to American Family Physician. Effective management of migraine headaches depends upon a good patient-physician relationship. "The Archives of Internal Medicine" reported in "Patient Treatment Preferences and the 5-HT1B/1D Agonists" that migraine sufferers consistently indicated the need for rapid, complete relief of symptoms and concomitant ability to return to previous activity levels with minimal side effects.
Over-the-Counter Medication
Many mild to moderate migraines, if identified early, can be successfully treated with over-the-counter (OTC) medications such as acetaminophen (Tylenol), ibuprofen (Motrin), or naproxen sodium (Aleve). Excedrin, a combination of acetaminophen, aspirin and caffeine, has also been effective in aborting a migraine attack, according to "The New England Journal of Medicine." Many migraines respond favorably to sleep, and physicians often take advantage of the sedative properties of an OTC medication like diphenhydramine (Benadryl), which is found in such products as Advil PM or Tylenol PM. Although these medications do provide relief for many patients, they are not specific migraine treatments and may not be effective for every patient and every migraine.
Non-Migraine-Specific Prescription Medication
Some migraine headaches may respond to an older drug (Midrin), which is a tablet combination of three drugs, including acetominophen. Therapies geared toward treating the accompanying nausea and vomiting induced by migraines can also help alleviate headache pain. Metoclopramide (Reglan), prochlorperazine (Compazine) and promethazine (Phenergan) are often prescribed for this purpose.
Narcotic medication is often prescribed, especially in an emergency room setting or in cases of migraines unresponsive to other treatment. Meperidine (Demerol), butorphanol (Stadol) and ketorolac (Toradol) can be administered by injection or through an IV. Hydrocodone (Vicodin) or oxycodone with acetaminophen (Percocet) can be prescribed in limited quantity for patients with frequent, severe migraines. Chronic use of narcotic medications, however, can lead to the formation of chronic, daily headaches and should be avoided.
Migraine-Specific Prescription Medication
Collectively known as triptans, this novel class of drugs has revolutionized the treatment of migraine headaches. According to "Migraines---Current Understanding and Treatment" published in the New England Journal of Medicine, these medications act to alleviate migraine pain by stimulating serotonin receptors in the brain and constricting blood vessels throughout the body. There are seven triptans in routine clinical use as of 2010: almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex) and zolmitriptan (Zomig). These medications provide patients with the option of several forms of administration: tablet/capsule, orally disintegrating tablet or wafer, subcutaneous injection and intranasal spray. Use of these medications may not be indicated for all migraine patients, and you should discuss the risk of possible side effects with your doctor.
