Migraine

Treatment:

Resting in a quiet, darkened room often reduces the severity of symptoms.

Several medications may be advised to relieve symptoms. The response of migraine to medications is highly variable. If a medication has been effective in relieving a previous migraine, it may be tried before others. Over-the-counter analgesics may reduce pain if they are taken early in the development of the headache. If over-the-counter analgesics are ineffective, vasoconstricting or other medications may be helpful. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or belladonna. Ergonovine maleate may relieve symptoms. Propoxyphene or other medications that relieve pain and/or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other antiemetics. Imitrex is a newly released medication that has been found very effective in the treatment of a migraine. It is self-administered as an injection under the skin (cost: about $35.00 per dose).

Any factors that have triggered a migraine in the past should be avoided.

Preventive medications include propranolol, amitriptyline, ergonovine, cyproheptadine, clonidine, methysergide, calcium channel antagonists, and others. Several medications may need to be tried before a medication that is effective in preventing migraine is found.

Expectations (prognosis):

The migraine will relieve with time. Treatment may reduce discomfort when the migraine is present, and may prevent future migraines.

Complications:

Other than discomfort, there are usually no complications.

Calling your health care provider:

Call for an appointment with your health care provider if this is the first time that you have had symptoms of migraine.

Call for an appointment if migraine symptoms are severe, persistent, recurrent, or accompanied by other symptoms.

Also call if previously effective treatments are no longer helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat, changes in skin color (pale or blue), extreme sleepiness or sedation, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain or cramps, dry mouth, extreme thirst, or others (see specific medication).

Call for an appointment with your health care provider if taking an ergotamine-containing medication and you are likely to become pregnant (these medications should not be taken when pregnant).