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How is migraine treated?
Migraine headache is treated by migraine prevention strategies and symptom alleviation. Many migraine sufferers rely on both preventive and abortive medications to stop the headache process.
Abortive medicine should be taken at the first sensation of migraine headache. Abortive migraine medications are designed to stop the headache process to prevent headache symptoms. Although many are available without a prescription, any medication should be taken strictly as physician recommended since some medicines should not be taken during an aura. Over-the-counter abortive migraine medications include ibuprofen, aspirin, ketoprofen, and naproxen. Prescribed abortive migraine medications include ergotamine, the vasoconstrictor combination of acetaminophen, isometheptene and dichloralphenazone, and serotonin receptor agonists, which include sumatriptan (trade name Imitrex), zolmitriptan (trade name Zomig), rizatriptan (trade name Maxalt), and naratriptan (trade name Amerge). Migraine nose spray, including Zomig and Imitrex nasal sprays, induces migraine relief faster, within 15 minutes, in many people.
Non-medication related abortive therapy includes lying in quiet darkness with a cold compress on the head, massage, and visualization to divert blood flow from the brain.
Prophylactic or preventive therapy includes avoiding inducers or triggers of migraine (such as certain foods, stress, or medications) and improving general health by getting ample rest and moderate exercise, minimizing stress, and eating well.
Since preventive drug therapy is administered daily, it is generally reserved for patients who suffer from migraines at least several times a month. The most commonly used preventive drug therapies are beta-blockers, which prevent vessel dilation, and include atenolol (trade name Tenormin), propanolol (trade name Inderal), and timolol (trade name Blocadren). Methysergide (trade name Sansert) blocks the effect of serotonin on vessel constriction, but causes serious side effects in some people. Calcium channel blockers, including diltiazem (trade name Cardizem), nicardipine (trade name Cardene), and nifedipine (trade name Procardia), are also administered to prevent migraine by causing vessel constriction. Anti-convulsants effectively prevent migraine headache in many people and include divalproex (trade name Depakene), valproic acid (trade name Depakote), and gabapentin (trade name Neurontin). In addition, nonsteroidal anti-inflammatories, tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs) are also administered in some patients for migraine prevention.
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