Migraines

What Are Migraines?

Migraines are a type of headache characterized by moderate to severe throbbing or pulsating pain, often on one side of the head. They can significantly impact daily life and may last from a few hours to several days.

Migraines often include other symptoms:

• Nausea or vomiting.

• Sensitivity to light, sound, or smells.

• Aura: Visual or sensory disturbances (e.g., flashing lights or tingling) that occur before or during a migraine in some patients.

What Triggers Migraines?

Common triggers include:

• Stress: Emotional or physical stress.

• Diet: Caffeine, alcohol, or skipped meals.

• Sleep Changes: Too much or too little sleep.

• Hormonal Fluctuations: Especially in women during menstruation.

• Environmental Factors: Bright lights, loud noises, or strong odors.

Treatment Options

There are two primary types of migraine treatments:

1. Rescue Medications

Used during a migraine attack to relieve symptoms. Examples include:

• Specific Options:

• Triptans (e.g., sumatriptan, rizatriptan): Target migraine pathways.

• CGRP antagonists (e.g., ubrogepant, rimegepant): Block proteins involved in migraine pain.

• GPANTs (e.g., atogepant): Another class targeting CGRP pathways.

• Unspecific Options:

• NSAIDs (e.g., ibuprofen, naproxen): Reduce pain and inflammation.

• Antiemetics (e.g., metoclopramide): Relieve nausea.

2. Preventive Medications

Taken daily to reduce the frequency and severity of migraines. Examples include:

• Specific Options:

• CGRP monoclonal antibodies (e.g., erenumab, fremanezumab): Prevent migraines by targeting CGRP pathways.

• Unspecific Options:

• Beta-blockers (e.g., propranolol).

• Antiepileptics (e.g., topiramate).

• Antidepressants (e.g., amitriptyline).

Non-Medication Approaches

• Lifestyle Adjustments: Maintaining regular sleep, exercise, and diet.

• Trigger Avoidance: Identifying and avoiding individual triggers.

• Stress Management: Relaxation techniques, such as yoga or meditation.

Common Myths About Migraines

1. “It’s just a headache.”

• Fact: Migraines are a neurological condition with distinct symptoms and significant impact on quality of life.

2. “Caffeine is bad for migraines.”

• Fact: Caffeine can trigger migraines for some, but it may also relieve mild migraines when used sparingly.

3. “Over-the-counter painkillers always help.”

• Fact: While OTC medications may relieve mild migraines, frequent use can lead to medication-overuse headaches.

When to Seek Help

Consult a doctor if:

• Your migraines are frequent or severe.

• Over-the-counter medications are ineffective.

• You experience new or unusual symptoms, such as sudden severe headache or neurological changes.

Your Role in Managing Migraines

• Track your migraines in a headache diary to identify patterns and triggers.

• Follow your doctor’s recommendations for treatment and lifestyle changes.

• Stay proactive with preventive strategies to reduce migraine frequency.