Headaches are something that cause discomfort in our life. Some people may have mild headaches that enable them to still do their daily life routine but some may experience severe ones that cause a person in need of medical care to feel better. Severe kinds of headaches are often associated with migraines. Those who have had migraines understand how medicine can bring great benefits for them and enable them to perform their daily activities as usual. We will learn more on migraine in this article and the top 5 migraine medications commonly used.
Migraines are neurological diseases that involve nerve pathways and chemicals. Migraine is often described as a severe headache. Migraine is found to be the 3rd highest cause worldwide of years lived with disability. The changes in the brain activity affect the blood in the brain and its surrounding tissue. This alone causes ranges of symptoms such as nausea, dizziness, extreme fatigue and increased sensitivity to light, sound or smells. Headaches itself is the main symptom of migraines.
A migraine episode may occur in 4 different phases, even not everyone may experience these phases. This includes:
- Prodrome phase- Also known as pre headache phase. Painless symptoms that occur hours or days before migraine occur. This includes mood swings, food cravings and neck stiffness.
- Aura phase- Auras refers to sensory sensitivity that occurs before or during migraine. Aura typically affects a person’s vision, touch or speech. Examples of auras include blurred vision, numbness in the arm and slurred speech. About a third of those with migraine experience this phase. This phase usually lasts for 5 minutes but may last up to hours or more.
- Headache phase- Headache that is painful, ranging from mild to severe. Physical activity and exposure to light, sound or smell may worsen the pain. This phase may be for hours or up to days.
- Postdrome phase- The pain subside and the patient may feel unwell. Some even say it is a migraine hangover as it feels similar to a hangover from alcoholic binge.
In most cases, people have migraine attacks once or twice a month. However, some people may have more migraine episodes more often. Migraines that occur more than 15 days a month for at least 3 months are considered as chronic migraines. Chronic migraines are so frequent and severe that it poses a challenge to have a normal life.
There are 2 major types of migraines. The first one is migraine with aura or also known as classic migraine aura and the second one is migraine without area or common migraine. Common migraine is the frequent form of migraine. Apart from these two types, there also other types of migraine such as abdominal migraine that mostly affects young children, basilar-type migraine that affects both children and adolescents, menstrual migraine that affects women around the time of the period, ophthalmoplegic migraine that is uncommon, retinal migraine and rare types such as status migrainosus, a severe type of acute migraine with intense pain and nausea, and hemiplegic migraine also being the severe one as it can cause paralysis of one side of body.
If you think you might have a migraine, it is important to speak to a healthcare provider. Diagnosis is usually made based on headache days. It is best for patients to keep track of the headache days as this can be great information for doctors in planning treatment. This means to include all kinds of headaches and does not necessarily count the severe ones only. Please avoid discounting the days that you think are not considered bad even when you already have the headaches.
Here are the top 5 medications migraine medications:
- Sumatriptan
- Eletriptan
- Zolmitriptan
- Ergots
- Antiemetics
You can see that the three most used drugs belongs to triptan drugs. Triptan works by increasing neurotransmitters serotonin in the brain. Serotonin causes constriction of blood vessels and helps in lowering the pain. It is also most preferred treatment for migraine as it can help to ease moderate to even severe migraine pain. Ergots also bind to serotonin receptors and lowers the pain transmission along nerve fibres. Ergots are most effective in the early stage of migraine. Antiemetics help to ease nausea that is associated with the various type of headache.
Effective treatment is needed for patient with migraine and the treatment need to be given and taken at the time of headache. Those with frequent and severe migraine may need preventive medications. Consideration for prevention are made when migraine occur one or more times a week, or if the migraine cause a person to be disabled despite the migraine are less frequent. Preventive medicines include beta blockers, calcium channel blockers, anticonvulsants and antidepressants. Beside medication, patient might want to invest in therapy such as biofeedback and relaxation training. Lifestyle changes including physical activity, eat healthy meals with sufficient hydration and avoiding triggers can further improve symptoms. It is also vital for patient to get good rest and a consistent sleep schedule.
