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Migraine treatment involves both treating acute attacks when they occur, and developing preventive strategies for reducing the frequency and severity of attacks.
Many effective headache remedies are available for treating a migraine attack. Still, many patients are treated with unapproved drugs, including opoids and barbiturates that can be potentially addictive or dangerous.
The main types of medications for treating a migraine attack are:
It is best to treat a migraine attack as soon as symptoms first occur. Doctors generally recommend starting with nonprescription pain relievers for mild-to-moderate attacks. If migraine pain is severe, a prescription version of an NSAID may be recommended. A triptan is generally the next drug of choice. Ergotamine drugs tend to be less effective than triptans, but are helpful for some patients. Depending on the severity of the attacks, and accompanying symptoms, the doctor may recommend taking a triptan or ergotamine drug in tablet, injection, or suppository form. The doctor may also prescribe specific medications for treating symptoms such as nausea.
Try to guard against rebound effect. Nearly all drugs used for migraine can cause rebound headache, and patients should not take any the drugs more than 9 days per month. If you find that you need to use acute migraine treatment more frequently, talk to your doctor about preventive medications.
Preventive strategies for migraine include both drug treatment and behavioral therapy or lifestyle adjustments.
Patients should consider using preventive migraine drugs if they have:
The main preventive drug treatments for migraine are:
A preventive medication strategy needs to be carefully tailored to an individual patient, taking into account the patient‚ ' s medical history and co-existing medical conditions. These drugs can have serious side effects.
A preventive medication is usually started at a low dose, and then gradually increased. It may take 2 - 3 months for a drug to achieve its full effect. Preventive treatment may be needed for 6 - 12 months or longer. Most patients take preventive medications on a daily basis, but some patients may use these drugs intermittently (for example, for preventing menstrual migraine).
Patients can also help prevent migraines by identifying and avoiding potential triggers, such as specific foods. Relaxation therapy and stress reduction techniques may also help. (See Lifestyle section below.)
Migraine Treatment for Children. Most children with migraines may need only mild pain relievers and home remedies (such as ginger tea) to treat their headaches. The American Academy of Neurology‚ ' s practice guidelines for children and adolescents recommend the following drug treatments:
Migraine Prevention for Children. Non-medication methods, including biofeedback and muscle relaxation techniques may be helpful. If these methods fail, then preventive drugs may be used, although evidence is weak on the effectiveness of standard migraine preventive drugs in children.
If medication overuse causes rebound migraines develop, the patients cannot recover without stopping the drugs. (If caffeine is the culprit, a person may need only to reduce coffee or tea drinking to a reasonable level, not necessarily stop drinking it altogether.) The patient can usually stop abruptly or gradually. The patient should expect the following:
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