Prevention of migraine

What is a migraine?

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Migraine is one of the most common types of primary headaches. The word “primary” means that such pain is not due to another disease. In fact, this is an independent disease, a kind of dysfunction of the brain.


How is migraine treated?

Migraine, like any other primary headache, cannot be cured completely, that is, removed once and for all. Scientists have not yet found such a way. But at the same time, doctors now know how to effectively treat migraines, that is, they get rid of attacks, make them weaker and less frequent.

There are two approaches to treating migraine with drugs:

  • when an attack occurs, it is eliminated with the help of a drug (stopped). For these purposes, ordinary painkillers are used (the fact that they do not help with migraines is a myth) or special medications that only help with
  • migraines – triptans;
  • prophylactic treatment is prescribed, that is, a constant, course intake – of other drugs.

What is Migraine Preventive Treatment

Prevention is used when attacks are frequent (more than four days a month) or are very difficult to tolerate and do not respond well to drugs for relief. The main goal is to reduce the number of days with headaches. If a person has a headache 20 days a month, but it starts to hurt 10, then prevention is working.

Preventive medications also help the drugs taken during an attack work and reduce the amount of pain relievers. This is important because over-reliance on painkillers often leads to new headaches. This type of pain is called drug-induced (or abusal) pain.

For the prophylactic treatment of migraine, drugs from a variety of groups are used, sometimes with a very unexpected purpose:

  • antiepileptic;
  • Beta blockers (medicines commonly used to lower blood pressure and slow heart rate)
  • AT1 receptor blockers – angiotensin receptors (amlodipine 10 mg & another cardiac drug);
  • antidepressants;
  • ACE inhibitors (and another cardiac);
  • botulinum toxin type A (Botox) – only for chronic migraine (≥ 15 days per month). The drug is administered not by a cosmetologist, but by a neurologist, this is done according to a special PREEMPT scheme

All of these drugs are not used to treat epilepsy, depression, or heart problems, but precisely because they help make migraine attacks less frequent and weaker. And for the prevention of migraine, not any, but only certain drugs from these groups are used.

Usually, prophylaxis begins with a small dosage of drugs and increases gradually to find the minimum effective dose. The dose is considered effective if the number of days with headache is halved or more. The course of prevention lasts from 6 to 12 months.

Posted by Dr.Pressurs in Headaches