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Axert (almotriptan) is an abortive migraine medication. Triptan medications work by working with serontonin receptors in the brain to decrease the inflammation that occurs during a migraine attack, effecting both blood vessels and nerves. As an abortive medications, it can stop a migraine in its tracks, relieving both pain AND neurological symptoms.
Keep in mind that there are many different kinds of triptan medication now. Just because one doesn't work for you, does not mean none of them will. Also, some of the triptan medications have different ways to administer them. Imitrex has injections, as well as a nasal spray and tablet. Maxalt has a subligual tablet which melts under the tongue, and Zomig does as well. These can be especially useful if nausea and vomiting is a predominant symptom of your migraines, because it offers you ways to get the medication in your system without worrying about throwing it up.
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Can you take Axert and Tylenol together?
Yes because Axert is a triptan class medication and Ibuprofen in a NSAID pain releiver which stands for non steroidal anti-inflammatory drug they are not in the same class so therefore they shouldn't react to each other in a negative way
Can you take Stadol nose spray and Axert migraine medications together?
== == Yes. Stadol is pain medication - opiate analgesic. (this medication can be very addictive, more addictive than regular opiates that come in tablets - because it works so fast) Axert is a triptan, which works with serotonin to constrict the blood vessels in your body.
What are examples of migraine drugs?
ergotamine (Cafergot), naratriptan (Amerge), sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), and zolmitriptan (Zomig).
Why does your headache feel worse after taking sumatriptan?
Some people react badly to sumatriptan, just as some people react badly to Penicillin. Treating migraines is all about trial and error, unfortunately. There may be other triptans you can take which do not cause you to feel worse (Zomig, Maxalt, Axert, Amerge, Relpax, Frova) I would not recommend Treximet, because that is just sumatriptan with naproxen added.
Are Imagran tablets for migrain?
Yes. Imigran and Imitrex, are both sumatriptan, a medication prescribed to treat abort migraine headaches. Imigran is the OTC version available in the UK. There are many other forms of triptan available by prescription (Zomig, Maxalt, Relpax, Axert, Amerge, Frova, Treximet). All of them work slightly differently, so where one might fail you, one might work. It is definitely work talking to your doctor about.
Is there a new shot or nasal spray for migraine headaches?
The triptans that are available now have been available for some time now. It doesn't look like there is much interest from the pharmaceutical companies in making sure that every triptan that comes out also comes out with an injection, dissolving tablet, or nasal spray. Keep in mind that just because you have tried one triptan medication does not mean you will respond the same to all of them. Many people respond better to one than another. Imitrex: tablet, nasal spray, injection Zomig: tablet, nasal spray, orally disintegrating tablet Maxalt: tablet, orally disintegrating tablet Axert: tablet Relpax: tablet Amerge: tablet Frova: tablet Treximet: tablet Treximet is the newest of the bunch. It contains Imitrex along with the main ingredient in Aleve (which can help it last longer, reduce inflammation better). If you absolutely need to have your triptan as an injection, you may want to try taking Imitrex as an injection, and then once the nausea dies down - taking a couple Aleve (or prescription Naproxen).
What are triptans?
The triptans are a class of medication used to abort migraine headaches. They can also be used on cluster headaches.They work by plugging into the serotonin receptors in the brain, so that more serotonin is used - which then constricts the blood vessels of the body. This is important, because it is the dilated blood vessels in part that cause so much throbbing pain. Unlike pain medications, triptans don't cover up a migraine - they stop the whole process - including nausea and light sensitivity. The sooner you take it, the better it works.There are seven different kinds of triptan. Each one works and binds in a slightly different way. Therefore, it is important to give all seven a chance. While several of them might not work for you, one might.Imitrex [tablet, nasal spray, injection]Maxalt [tablet, sublingual dissolving pill]Zomig [tablet, sublingual, nasal spray]Relpax [tablet]Amerge [tablet]Axert [tablet]Frova [tablet] (used for menstrual migraine cycles, because it lasts for 24 hours)If you have hemiplegic or basilar migraines, or have heart disease - then the triptans are not for you. For people with risk factors, they can cause heart attack and stroke.As with any abortive medication, triptans can cause rebound headache. The gold standard is to not take any abortive medication more than two times a week. This is especially important with the triptans, because they will stop working over time. Headache specialists suggest that a migraineur might put off their triptans' demise by alternating between one or two different triptans, so you aren't consistently using the same one.The FDA has approved the triptan Treximet. It is not a new triptan, simply Imitrex (sumatriptan) repackaged with some Aleve (naproxen) mixed in. Studies have shown that by adding a dose of an anti-inflammatory NSAID like naproxen to sumatriptan, you increase its effectiveness and longevity.
Serotonin syndrome?
DefinitionSerotonin syndrome is a potentialyl life-threatening drug reaction that causes the body to have too much serotonin, a chemical produced by nerve cells.Alternative NamesHyperserotonemia; Serotonergic syndromeCauses, incidence, and risk factorsSerotonin syndrome most often occurs when two drugs that affect the body's level of serotonin are taken together at the same time. The drugs cause too much serotonin to be released or to remain in the brain area.For example, you can develop this syndrome if you take migraine medicines called triptans together with antidepressants called selective serotonin reuptake inhibitors (SSRIs) and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs). Popular SSRI's include Celexa, Zoloft, Prozac, Zoloft, Paxil, and Lexapro. SNRI's include Cymbalta and Effexor. Brand names of triptans include Imitrex, Zomig, Frova, Maxalt, Axert, Amerge, and Relpax.The FDA recently asked the manufacturers of these types of drugs to include warning labels on their products that tell you about the potential risk of serotonin syndrome. Talk to your doctor before stopping any medication.Serotonin syndrome is more likely to occur when you first start or increase the medicine.Older antidepressants called monoamine oxidase inhibitors (MAOIs) can also cause serotonin syndrome with the medicines describe above, as well as meperidine (Demerol, a painkiller) or dextromethorphan (cough medicine).Drugs of abuse, such as ecstasy and LSD have also been associated with serotonin syndrome.SymptomsSymptoms occur within minutes to hours, and may include:Agitation or restlessnessDiarrheaFast heart beatHallucinationsIncreased body temperatureLoss of coordinationNauseaOveractive reflexesRapid changes in blood pressureVomitingSigns and testsThe diagnosis is usually made by asking questions about your medical history, including the types of drugs you take.To be diagnosed with serotonin syndrome, you must have been taking a drug that changes the body's serotonin levels (serotonergic drug) and have at least three of the following signs or symptoms:AgitationDiarrheaHeavy sweating not due to activityFeverMental status changes such as confusion or hypomaniaMuscle spasms (myoclonus)Overactive reflexes (hyperreflexia)ShiveringTremorUncoordinated movements (ataxia)Serotonin syndrome is not diagnosed until all other possible causes have been ruled out, including infections, intoxications, metabolic and hormone problems, and drug withdrawal. Some symptoms of serotonin syndrome can mimic those due to an overdose of cocaine, lithium, or an MAOI.If you have just start taking or increased the dosage of a tranquilizer (neuroleptic drug), other conditions such as neuroleptic malignant syndrome will be considered.Tests may include:Blood cultures (to check for infection)Complete blood count (CBC)Drug (toxicology) screenElectrolyte levelsElectrocardiogram (ECG)Kidney and liver function testsThyroid function testsTreatmentPatients with serotonin syndrome should stay in the hospital for at least 24 hours for close observation.Treatment may include:Benzodiazepines such as diazepam (Valium) or lorazepam (Ativan) to decrease agitation, seizure-like movements, and muscle stiffnessCyproheptadine (Periactin), a drug that blocks serotonin productionFluids by IVWithdrawal of medicines that caused the syndromeIn life-threatening cases, medicines that keep your muscles still (paralyze them) and a temporary breathing tube and breathing machine will be needed to prevent further muscle damage.Expectations (prognosis)Patients may get slowly worse and can become severely ill if not quickly treated. Untreated serotonin syndrome can be deadly. However, with treatment, symptoms can usually go away in less than 24 hours.ComplicationsUncontrolled muscle spasms can cause severe muscle breakdown. The products produced when the muscles break down are released into your blood and eventually go through the kidneys. This can cause severe kidney damage if not recognized and treated appropriately. With appropriate treatment, the condition is reversible.Calling your health care providerCall your health care provider right away if you have symptoms of serotonin syndrome. PreventionAlways tell all of your healthcare providers what medicines you take. Patients who take triptans with SSRIs or SNRIs should be closely followed, especially right after starting a medicine or increasing its dosage.ReferencesUS Food and Drug Administration. FDA Public Health Advisory: Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome. Rockville, MD: Center for Drug Evaluation and Research; July 19, 2006.Prator BC. Serotonin syndrome. J Neurosci Nurs. 2006 Apr;38(2):102-5.Ford MD, Clinical Toxicology. 1st ed. Philadelphia, Pa: WB Saunders; 2001:150, 522, 547, 550.Bilden EF, Walter FG. Antidepressants. In Marx J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006: chap 149.Sternbach H. The Serotonin Syndrome. Am J Psychiatry. 1991: 148:705.Parrot AC. Recreational Ecstasy/MDMA, the serotonin syndrome, and serotonergic neurotoxicity. Pharmacol Biochem Behav. 2002 Apr;71(4):837-44. Review.Brent J, Palmer R. Monoamine oxidase inhibitors and serotonin syndrome. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 29.
Who do you go to when you are on day 59 of migraine Been to Neuro they have me on topomax and amytrip treximet and Maxalt Xanax is no longer helping Wtf do I do Can't take it anymore pls help?
One Answer:See an Acupuncturist! Obviously something is out of balance with your body and this will help. You have the option of relief care or corrective care. I personally receive acupuncture every week and my problems (which are deeply rooted) are slowly but surely moving on. Another Answer: (this is going to be extremely long)If you are on day 59 of migraine, and your migraine has not ceased for at least 4 hours time, it is necessary and your right to ask for more aggressive treatment. Whenever you have a migraine which lasts for 72 hours without a break, you may need to be admitted to the hospital for treatment by IV by a medication such as DHE, Valproic Acid, or a number of other medications.At the very least, ask your neurologist to try a steroid dose pack to break the current cycle.You also may want to ask if you can be referred to a pain specialist to receive treatment such as a Greater Occipital Nerve Block.Your neurologist is using the two of the medications shown to be most successful in preventing migraines and/or reducing the pain associated with them. Keep in mind it can take at leastthree months for your neurologist to be able to tell whether or not your current preventative regime is likely to benefit you. There are many, many, many other preventative medications out there. I know the trial and error process we go through is beyond frustrating and frequently heartbreaking when medications don't pan out. Just know that you are not at the end of the line yet.Treximet and Maxalt are part of a group of abortive medications called the triptans. Treximet is simply Imitrex with Naproxen (the active ingredient in Aleve). Naproxen is an NSAID (non-steroidal anti-inflammatory). NSAIDs are used in treating migraines because they deal with the inflammation which is part of the migraine process, as well as reducing prostaglandins - which are chemicals in the body which play a large role in pain and the sensitivity the body has to it.Besides Imitrex, Treximet, and Maxalt - there are other medications in the triptan category. One of them may work for you - and keep in mind, you can always speak to your doctor about adding Naproxen to any of the triptans. You may even ask if injectable Imitrex while taking Naproxen.A list of the other triptans: Zomig, Axert, Amerge, Relpax, FrovaIf you haven't already, begin keeping a headache diary. Even though you are in pain every day, it is still important to keep the diary of how you are doing, how active you are able to be, and where your pain levels are at. By doing this, you may be able to see overall patterns - such as if your current preventive regimen is beginning to slowing work, or find triggers you may be able to avoid.Keep in mind that there is a type of chronic migraine called Medication Overuse Headache. Medication Overuse includes the use of OTC medications such as Tylenol, as well as prescribed painkillers which contain narcotic medications (codeine, oxycodone, hydrocodone) AND Tylenol. Medication overuse is also associated with overuse of triptans. You are a good candidate for chronic migraine due to medication overuse if are taking these types of medications more than 3 days a week to more than 15 days a month. The only way to determine if Medication Overuse is the culprit is to remove the offending medications completely for several months. It is very, very hard, but worth it when after that time there is a reduction in the number of days you are in pain.When keeping a headache diary, you may wish to begin documenting the medications you are taking to abort or relieve your head pain, because many times - when you take something in the depths of pain - all you are thinking of is getting relief, and you may not realize how many days out of the month you are taking these medications.It is a completely normal feeling to want and seek relief of the pain you are experiencing, and medication overuse headache is not an addiction disorder. It simply means that your body has become entrapped in a headache cycle due to becoming accustomed the medication you are taking.Natural Methods:Note: Please note that you should still be informing your neurologist of all Vitamin/Mineral and Herbal supplements you may decide to take. (For example, feverfew is an herb used to abort migraines - it works as a vasocontrictor - which the triptan medications also do. So it may not be wise to take them together).There are a number of natural ways to try and help yourself prevent migraines or at the very least reduce your pain levels. Some of these are Vitamin B2, Magnesium, Fish Oil, and Vitamin D. These have been found in scientific studies to be beneficial in the treatment of migraines. People with chronic pain, as well as people who are in chronic pain from other issues, are often found to be deficient in magnesium and Vitamin D. Both of these necessary nutrients have been shown to reduce pain or increase the pain threshold in patients.A more recent natural ingredient used to treat migraine is intranasal capsaicin. Yes, capsaicin is the ingredient in hot peppers. Feel free to cringe at the idea of inhaling it. However, studies have shown that it may have an immediate ability to abort migraine and cluster headache, and even if it cannot successfully abort migraines or cluster headache, when it is repeatedly used over time, it can significantly reduce the two pain disorder's ability to be triggered. This is because repeated use of capsaicin against the nerve fibres it comes into contact with toughens them up - not only so that the capsaicin doesn't burn as much anymore, but that the nerves are resistant to other stimuli as well.There are different companies that make capsaicin nasal sprays and they are not insanely expensive. Please be aware of other herbal ingredients some of them contain.I am adding a link to this question that you most definitely should check out - a website created by a sufferer of migraines who is intensely knowledgeble and an advocate. She has things on her website such as downloadable diaries and lists of the medications used to treat migraine, including a list of IV medications that can be used in the hospital to try and break intractable migraines.I know it is not easy - but don't give up. You still have so many options before you.
Headache?
DefinitionA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are extremely rare. Most people with headaches can feel much better by making lifestyle changes, learning ways to relax, and occasionally by taking medications.See also:Cluster headacheMigraineTension headacheAlternative NamesPain - head; Rebound headaches; Medication overuse headachesCommon CausesThe most common headaches are probably caused by tight, contracted muscles in your shoulders, neck, scalp, and jaw. These are called tension headaches. They are often related to stress, depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to them. Headaches can be triggered by chocolate, cheese, and monosodium glutamate (MSG). People who drink caffeine can have headaches when they don't get their usual daily amount.Other common causes include:Holding your head in one position for a long time, like at a computer, microscope, or typewriterPoor sleep positionOverexerting yourselfClenching or grinding your teethTension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight and sore. The pain is usually persistent, but does not get worse with activity.Migraine headaches are severe headaches that usually occur with other symptoms such as visual disturbances or nausea. The pain may be described as throbbing, pounding, or pulsating. It tends to begin on one side of your head, although it may spread to both sides. You may have an "aura" (a group of warning symptoms that start before your headache). The pain usually gets worse as you try to move around. For more information on this type of headache, see: migraine.Other types of headaches:Cluster headaches are sharp, extremely painful headaches that tend to occur several times per day for months and then go away for a similar period. They are far less common.Sinus headaches cause pain in the front of your head and face. They are due to inflammation in the sinus passages that lie behind the cheeks, nose, and eyes. The pain tends to be worse when you bend forward and when you first wake up in the morning. Postnasal drip, sore throat, and nasal discharge usually occur with these headaches.Headaches may occur if you have a cold, the flu, fever, or premenstrual syndrome.If you are over age 50 and are experiencing headaches for the first time, a condition called temporal arteritis may prove to be the cause. Symptoms of this condition include impaired vision and pain aggravated by chewing. There is a risk of becoming blind with this condition. Therefore, it must be treated by your doctor right away.Rare causes of headache include:Brain aneurysm-- a weakening of the wall of a blood vessel that can rupture and bleed into the brainBrain tumorStroke or TIABrain infection like meningitis or encephalitisHome CareKeep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches. When a headache occurs, write down the date and time the headache began, what you ate for the past 24 hours, how long you slept the night before, what you were doing and thinking about just before the headache started, any stress in your life, how long the headache lasts, and what you did to make it stop. After a period of time, you may begin to see a pattern.A headache may be relieved by resting with your eyes closed and head supported. Relaxation techniques can help. A massage or heat applied to the back of the upper neck can be effective in relieving tension headaches.Try acetaminophen, aspirin, or ibuprofen for tension headaches. Do NOT give aspirin to children because of the risk of Reye syndrome.Migraine headaches may respond to nonsteroidal anti-inflammatory drugs (NSAIDs), or migraine medications that contain a combination of drugs.If over-the-counter remedies do not control your pain, talk to your doctor about possible prescription medications.Prescription medications used for migraine headaches include ergotamine, dihydroergotamine, ergotamine with caffeine (Cafergot), isometheptene (Midrin), and triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), eletriptan (Relpax), almotriptan (Axert), and zolmitriptan (Zomig). Sometimes medications to relieve nausea and vomiting are helpful for other migraine symptoms.If you get headaches often, your doctor may prescribe medication to prevent headaches before they occur. It is important to take these medicines every day as prescribed, even when you are not having a headache.People who take pain medications regularly for 3 or more days a week may develop medication overuse, or rebound, headaches. All types of pain pills (including over-the-counter drugs) can cause rebound headaches. If you think this may be a problem for you, talk to your health care provider.Call your health care provider ifTake the following symptoms seriously. If you cannot see your health care provider immediately, go to the emergency room or call 911 if:This is the first headache you have ever had in your life and it interferes with your daily activitiesYour headache comes on suddenly and is explosive or violentYou would describe your headache as "your worst ever" even if you are prone to headachesYour headache is associated with slurred speech, change in vision, problems moving your arms or legs, loss of balance, confusion, or memory lossYour headache gets progressively worse over a 24-hour periodYour headache is accompanied by fever, stiff neck, nausea, and vomitingYour headache occurs with a head injuryYour headache is severe and localized to one eye with redness in that eyeYou are over age 50 and your headaches just began, especially with impaired vision and pain while chewingYou have cancer and develop a new headacheSee your provider soon if:Your headaches wake you up from sleepA headache lasts more than a few daysHeadaches are worse in the morningYou have a history of headaches but they have changed in pattern or intensityYou have headaches frequently, and there is no known causeWhat to expect at your health care provider's officeYour health care provider will obtain your medical history and will perform an examination of your head, eyes, ears, nose, throat, neck, and nervous system.The diagnosis is usually based on your history of symptoms. A "headache diary" may be helpful for recording information about headaches over a period of time. Your doctor may ask questions such as the following:Is the headache located in the forehead, around the eyes, in the back of the head, near the temples, behind the eyeball, or all over?Is the headache on one side only?Is this a new type of headache for you?Would you describe the headache as throbbing?Is there a pressure or band-like sensation?When does the headache occur? How long have you had headaches? How long does each headache last?Does the headache awaken you from sleep? Are the headaches worse during the day and better at night?Did other symptoms begin shortly after the headaches began? Do headaches occur repeatedly?Does the headache reach maximum intensity over 1 to 2 hours?Are the headaches worse when you are lying down? Standing up?Are the headaches worse when you cough or strain?Do they occur at a specific time related to your menstrual period?What home treatment have you tried? How effective was it?Diagnostic tests that may be performed include the following:Head CT scanHead MRISinus x-raysTemporal artery biopsyLumbar punctureIf a migraine is diagnosed, medications that contain ergot may be prescribed. Temporal arteritis must be treated with steroids to help prevent blindness. Other disorders are treated as is appropriate.PreventionThe following healthy habits can lessen stress and reduce your chance of getting headaches:Getting adequate sleepEating a healthy dietExercising regularlyStretching your neck and upper body, especially if your work involves typing or using a computerLearning proper postureQuitting smokingLearning to relax using meditation, deep breathing, yoga, or other techniquesWearing proper eyeglasses, if neededReferencesLipton RB, Bigal ME, Steiner TJ, Silberstein SD, Olesen J. Classification of primary headaches. Neurology. 2004;63(3):427-435.Silberstein SD, Young WB. Headache and facial pain. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: WB Saunders; 2007:chap 53.Wilson JF. In the clinic: migraine. Ann Intern Med. 2007;147(9): ITC11-1-ITC11-16.Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. 2008:7(1):70-83.
Migraine?
DefinitionA migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.See also:Cluster headacheMixed tension migraine (features of both a migraine and tension headache)Tension headacheAlternative NamesHeadache - migraineCauses, incidence, and risk factorsA lot of people get migraines -- about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.A migraine is caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or something else. However, the exact chain of events remains unclear.Scientists used to believe that migraines were due to changes in blood vessels within the brain. Today, most medical experts believe the attack actually begins in the brain itself, where it involves various nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.Migraine attacks may be triggered by:AlcoholAllergic reactionsBright lightsCertain odors or perfumesChanges in hormone levels (which can occur during a woman's menstrual cycle or with the use of birth control pills)Changes in sleep patternsExerciseLoud noisesMissed mealsPhysical or emotional stressSmoking or exposure to smokeCertain foods and preservatives in foods may trigger migraines in some people. Food-related triggers may include:Any processed, fermented, pickled, or marinated foodsBaked goodsChocolateDairy productsFoods containing monosodium glutamate (MSG)Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beansFruits (avocado, banana, citrus fruit)Meats containing nitrates (bacon, hot dogs, salami, cured meats)NutsOnionsPeanut butterThis list may not include all triggers.True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition.SymptomsVision disturbances, or aura, are considered a "warning sign" that a migraine is coming. The aura occurs in both eyes and may involve any or all of the following:A temporary blind spotBlurred visionEye painSeeing stars or zigzag linesTunnel visionNot every person with migraines has an aura. Those who do usually develop one about 10 - 15 minutes before the headache. However, it may occur just a few minutes to 24 hours beforehand. A headache may not always follow an aura.Migraine headaches can be dull or severe. The pain may be felt behind the eye or in the back of the head and neck. For many patients, the headaches start on the same side each time. The headaches usually:Feel throbbing, pounding, or pulsatingAre worse on one side of the headStart as a dull ache and get worse within minutes to hoursLast 6 to 48 hoursOther symptoms that may occur with the headache include:ChillsIncreased urinationFatigueLoss of appetiteNausea and vomitingNumbness, tingling, or weaknessProblems concentrating, trouble finding wordsSensitivity to light or soundSweatingSymptoms may linger even after the migraine has gone away. Patients with migraine sometimes call this a migraine "hangover." Symptoms can include:Feeling mentally dull, like your thinking is not clear or sharpIncreased need for sleepNeck painSigns and testsYour doctor can diagnose this type of headache by asking questions about your symptoms and family history of migraines. A complete physical exam will be done to determine if your headaches are due to muscle tension, sinus problems, or a serious brain disorder.There is no specific test to prove that your headache is actually a migraine. However, your doctor may order a brain MRI or CT scan if you have never had one before.If you have a migraine with unusual symptoms such as weakness, memory problems, or loss of alertness, an EEG may be needed to rule out seizures. A lumbar puncture (spinal tap) might be done.TreatmentThere is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or changing your triggers.A good way to identify triggers is to keep a headache diary. Write down:When your headaches occurHow severe they areWhat you've eatenHow much sleep you hadOther symptomsOther possible factors (women should note where they are in their menstrual cycle)For example, the diary may reveal that your headaches tend to occur more often on days when you wake up earlier than usual. Changing your sleep schedule may result in fewer migraine attacks.When you do get migraine symptoms, try to treat them right away. The headache may be less severe. When migraine symptoms begin:Drink water to avoid dehydration, especially if you have vomitedRest in a quiet, darkened roomPlace a cool cloth on your headMany different medications are available for people with migraines. Medicines are used to:Reduce the number of attacksStop the migraine once early symptoms occurTreat the pain and other symptomsREDUCING ATTACKSIf you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. Such medicine needs to be taken every day in order to be effective. Such medications may include:Antidepressants such as amitriptylineBlood pressure medicines such as beta blockers (propanolol) or calcium channel blockers (verapamil)Seizure medication such as valproic acid, gabepentin, and topiramateSerotonin reuptake inhibitors (SSRIs) such as venlafaxineSelective norepinephrine uptake inhibitor (SNRIs) such as duloxetineSTOPPING AN ATTACKOther medicines are taken at the first sign of a migraine attack. Over-the-counter pain medications such as acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. If these don't help, ask your doctor about prescription medications. (Be aware, however, that overuse or misuse of such pain medications may result in rebound headaches.Chronic rebound headaches typically occur in people who take pain medications more than 3 days a week on an ongoing basis.)Your doctor can select from several different types of medications, including:Triptans -- the most frequently prescribed medicines for stopping migraine attacks -- such as almotriptan (Axert), frovatriptan (Frova), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)Ergots such as dihydroergotamine or ergotamine with caffeine (Cafergot)Isometheptene (Midrin)These medications come in different forms. Patients who have nausea and vomiting with their migraines may be prescribed a nasal spray, suppository, or injection instead of pills.Some migraine medicines narrow your blood vessels and should not be used if you are at risk for heart attacks or have heart disease, unless otherwise instructed by your health care provider. Ergots should not be taken if you are pregnant or planning to become pregnant, because they can cause serious side effects to an unborn baby.TREATING SYMPTOMSOther medications are primarily given to treat the symptoms of migraine. Used alone or in combinations, these drugs can reduce your pain, nausea, or emotional distress. Medications in this group include:Nausea medicines such as prochlorperazineOver-the-counter pain relievers such as acetaminophen (Tylenol)Sedatives such as butalbitalNarcotic pain relievers such as meperidineNonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofenIf you wish to consider an alternative, feverfew is a popular herb for migraines. Several studies, but not all, support using feverfew for treating migraines. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.Support GroupsAmerican Council for Headache Education - www.achenet.orgThe National Migraine Association - www.migraines.orgNational Headache Foundation - www.headaches.orgExpectations (prognosis)Every person responds differently to treatment. Some people have rare headaches that require little to no treatment. Others require the use of several medications or even occasional hospitalization.ComplicationsMigraine headache is a risk factor for stroke in both men and women.Migraine headaches generally represent no significant threat to your overall health. However, they can be a long-term (chronic) problem and may interfere with your day-to-day life.Calling your health care providerCall 911 if:You are experiencing "the worst headache of your life"You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a migraine beforeYour headaches are more severe when lying downThe headache starts very suddenlyAlso, call your doctor if:Your headache patterns or pain changeTreatments that once worked are no longer helpfulYou have side effects from medication, including irregular heartbeat, pale or blue skin, extreme sleepiness, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain, cramps, dry mouth, or extreme thirstYou are pregnant or could become pregnant -- some medications should not be taken when pregnantSee the general article on headaches for more information on emergency symptomsPreventionUnderstanding your headache triggers can help you avoid foods and situations that cause your migraines. Keep a headache diary to help identify the source or trigger of your symptoms. Then modify your environment or habits to avoid future headaches.Other tips for preventing migraines include:Avoid smokingAvoid alcoholAvoid artificial sweeteners and other known food-related triggersGet regular exerciseGet plenty of sleep each nightLearn to relax and reduce stress -- some patients have found that biofeedback and self-hypnosis helps reduce the number of migraine attacksReferencesWilson JF. In the clinic: migraine. Ann Intern Med. 2007;147(9):ITC11-1-ITC11-16.Ebell MH. Diagnosis of migraine headache. Am Fam Physician. 2006;74(12):2087-2088.Detsky ME, McDonald DR, et al. Does this patient with headache have a migraine or need neuroimaging? JAMA. 2006;296(10):1274-1283.Lipton RB, Bigal ME, Steiner TJ, Silberstein SD, Olesen J. Classification of primary headaches. Neurology. 2004;63(3):427-435.Silberstein SD, Young WB. Headache and facial pain. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. St. Louis, Mo: WB Saunders; 2007:chap. 53.
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