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How Is Migraine Disorder Treated?
Treatment for migraines usually involves medications, and the medications prescribed generally fall into one of two categories. Pain-relieving medications are taken during an attack, and their goal is to lessen the severity of symptoms or to decrease the duration of the attack. Preventive medications are intended to prevent migraines from occurring or to lessen their severity when they do occur.
Medications taken during attacks are most effective when they’re administered at the earliest possible sign of an impending migraine. Many sufferers find relief by taking over-the-counter pain relievers such as aspirin or ibuprofen, but if taken excessively over a long period of time, they can cause side effects such as overuse headaches and gastrointestinal problems.
Other pain-relieving medications include:
- Triptans. Prescription pain relievers such as sumatriptan and rizatriptan are often prescribed for migraine sufferers, but they may not be suitable for patients at risk for heart attack or stroke.
- Dihydroergotamines. These drugs are effective at treating long-lasting migraines when they’re administered early. They may cause nausea, and they are not suitable for patients with coronary artery disease, high blood pressure, or kidney or liver disease.
- Opioid pain relievers. These strong pain relievers are sometimes prescribed for those who are unable to use other medications. The high risk of addiction to these drugs, however, makes them a less-than-ideal choice.
- Anti-nausea drugs. Chlorpromazine, metoclopramide, or prochlorperazine are sometimes used to treat the symptoms of the aura phase.
Preventive medications are sometimes prescribed when a sufferer has frequent migraines, or when their migraines don’t respond well to other treatments. Some blood pressure medications, antidepressants, and anti-seizure medications have shown effectiveness in preventing migraines or decreasing their severity. For some people, botox injections seem to prevent migraines, as well.
The Food and Drug Administration has recently approved a class of drugs called calcitonin gene-related peptide (CGRP) monoclonal antibodies for preventive treatment of migraines. These drugs–erenumab-aooe, fremanezumab-vfrm, and galcanezumab-gnlm–are administered via monthly injections.
Many non-drug treatments may also help to prevent migraines or make them less debilitating when they do occur. Alternative therapies include:
- Relaxation or meditation techniques
- Psychotherapy, especially cognitive-behavioral therapy (CBT)
- Nutritional supplements such as vitamin B-2, magnesium, and coenzyme Q10
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