Treatment for migraine
• Treatment is usually very successful but can require a battery of medicines to deal with the problem, because each attack may be different. Most people will have tried painkillers such as aspirin or paracetamol but sometimes, just for one dose, three tablets, rather than the usual two, may make all the difference.
• One of the main problems is that during a migraine attack the stomach contents are static. This means that tablets taken are not well absorbed and therefore don’t work efficiently. Sometimes a doctor will prescribe medication to stop sickness and nausea and help empty the stomach, which will enable the painkiller to be more effective.
• Tablets containing codeine are not recommended because they can create dependence and a rebound headache once they are stopped. Anti-inflammatory tablets, such as ibuprofen, work for some people.
• New migraine-specific drugs called triptans, which control the changes in blood vessels that cause the migraine, have recently become available. These need to be prescribed by a doctor and come in the form of tablets, rapidly melting tablets, nasal sprays and injections for those whose migraine starts with vomiting.
• About three times more women than men are affected by migraine, and this is probably hormone related. Women with migraine react individually to extra hormones. About a third benefit from taking the contraceptive pill, in a third it makes little difference and in a third the migraine gets worse and the pill should be stopped. In that very rare group of women who have a numbness or weakness of part of the body when they have a migraine attack, the pill should definitely not be taken. During pregnancy, many women have fewer attacks and they may even disappear. A few have a really difficult time.
• For those troubled with very frequent attacks of migraine who find that painkillers don’t work, daily preventive medicines such as beta-blockers (which help regulate heart rhythm) may reduce the severity and frequency of the attacks, but these may also have side-effects.
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