Migraine Headaches

Treating a Migraine

There are two general types of treatments when it comes to treating migraines: abortive and preventative. Abortive medications are designed to stop the migraine once it has started. These include:

• Non-steroidal anti-inflammatory medications (NSAIDs). Ibuprofen (Motrin), diclofenac (diclofenac), etc.
• Narcotic pain relievers. Darvocet, Percocet, etc.
• Ergots. Ergotamine, dihydroergotamine, etc.
• 5-HT receptor agonists ("Triptans"). sumatriptan (Imitrex), zolmitriptan (Zomig), etc.
• Barbiturate combinations. Fioricet.

Preventative medications are designed to stop headaches before they start. This can be an effective treatment strategy for those who suffer from frequent or regular migraines. There are four FDA-approved medications for migraine prevention: propranolol (Inderal), timolol (Blocadren), topiramate (Topamax) and divalproex sodium (Depakote). Should one of these not work, your health care provider may choose to use a medication that is not formally approved for migraine prevention, but that has a good track record for its use. These medications include:

• Beta-blockers. Atenolol (Tenormin), long-acting metoprolol (Toprol XL), etc.
• Antidepressants. Amitriptyline, fluoxetine (Prozac), etc.
• Anticonvulsants. gabapentin (Neurontin), etc.
• Others. Lisinopril (Zestril), candesartan (Atacand), and verapamil (Calan) are among some of the choices.

Your health care provider can best assist you in selecting the most appropriate treatment choices for you.

_Sources:

_{Auckerman, G, et al. Management of the acute migraine headache. Am Fam Physician. 2002 Dec 1;66(11):2123-30.}

_{DeMaagd, George. Migraine headaches: the pharmacist and the role of OTC medications. Pharmacy Times. March 2007.}

_{Drugs for migraine. Treatment guidelines from The Medical Letter, 2004;2:63-66.}

_{Migraine. National Headache Foundation. Retrieved: December 9, 2008. http://www.headaches.org/education/Headache_Topic_Sheets/Migraine}

_{Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Physician. 2006 Nov 15;74(10):1685. Retrieved: December 9, 2008. http://www.aafp.org/afp/20060101/72.html}

_{Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotension II receptor blocker: a randomized controlled trial. JAMA, 2003;289:65-9.}

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