Medications
The next group is the ergot derivatives. Ergotamine (Cafergot) has been around longer than the triptants and also works by constricting blood vessels. But it can nausea and vomiting. So your doctor may prescribe an antinausea drug to go with it. Methysergide (Deseril) is very effective but used only if other choices don't work; its side effects range from nausea, vomiting, abdominal pain, diarrhoea and depression, to a rare but potentially fatal lung fibrosis (excessive scar tissue). If pain relief continues to elude you, however, the next step is a powerful opiate, such as morphine, codeine or oxycodone (Endone, Proladone).
Less effective than prescription drugs and useful only for mild cases, nonprescription pain relievers include paracetamol (Panadol) and paracetamol and codeine combinations (Panadeine), and non-steroidal anit-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Naprogesic, Aleve) and ibuprofen (Nurofen). Other over-the-counter analgesis including dextropropoxyphene (Digesic, Capadex) and aspirin/codeine combinations (Codral Forte, Disprin Forte) can also be useful to provide itself.
There are also preventive medications to stave off migraines. Options include a daily aspirin; prescription beta-blockers, such as propranolol (Inderal), which provides long-term relief for about half of those with frequent migraines; calicum channel blockers, such as verapamil; tricyclic antidepressants, such as amitriptyline (Tryptanol, Endep) and nortryptiline (Allegron); and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Aropax).
HOW TO KEEP A MIGRAINE DIARY
Okay, it's time to play detective. The trench-coat and magnifying glass are optional, but pen and paper are required. The best way to idenify potential migraine triggers is to keep a diary of what happened immdiately before an attack. The information will be invaluable in helping you and your doctor figure out the best course of treatment for your headaches. Here's what you'll need to write down:
Medications are not your only defence. When a migraine strikes, lie down in a dark room. Place an ice pack or gel pack wherever the pain is. A headband--either elastic or gel-filled (and cooled)--can also offer some relief. In addition, other lifestyle measures can minimise your attacks. The key is to identify and eliminate your triggers. Here's how:
Watch your diet. Many foods and drinks have been linked to migraines. Among the likely suspects are foods which contain nitrates (bacon, corned beef, ham, hot dogs, luncheon meats and sausage); the chemical MSG (monosodium glutamate); aged cheeses (Cheddar, Swiss, Stilton, Brie); chocolate; nuts; peanut butter; sour cream; caffeinated beverages; aspartame (aritificial sweetener); and alochol.
Eat regularly. Skipping meals is a common migraine trigger.
Get a good night's sleep. Too much or too little sleep can cause a migraine. Your best bet is to establish to consistent sleep pattern of seven to nine hours nightly. Keep in mind that changes to this pattern, including jet lag and broken sleep, can also trigger a migraine.
Exercise smart. Always warm up properly and ease into your workout, as it is thought that aerobic exercise can sometimes make migraines worse.
Cluster headaches
-------------------------------------------------------------------------------------------------------------------------------
This rare form of headaches strikes about 1 percent of people, and the overwhelming majority--are estimated 85 percent--are men. Its key symptom is distinctive: intense pain around one eye, lasting from 15 minutes to 2 hours. The name is descriptive. These headaches tend to come in clusters, occuring repeatedly (often at the same time of night) for several weeks or months. A common pattern is for the headache to attack a few hours after you fall asleep, during rapid eye movement (REM) sleep.
The cause of cluster headaches remains a mystery. Because cigarettes and alcohol are often triggers, heavy smokers and drinkers are at the greastest risk. While lying down may help relieve migraine pain, it can have the opposite effect on a cluster headache. Since the attacks are so short and intense, it's difficult for any drug to work quickly enough to help. In some people, breathing pure oxygen through a mask from an oxygen tank for about 10 minutes at the start of an attack provides the most effective relief. Because the headaches come in clusters, you best bet for preventive medication may be naratriptan (Naramig), which gives you long-term coverage.
A daily cup of yoghurt may help to prevent migraine headaches, according to Italian researchers. They estimated that 18% of chronic migraine sufferers are infected with the bacteria Helicobacter pylori, which has been linked to ulcers, heart disease and other health problems. The researchers split 130 people who had migraines and H. pylori into two groups, giving half antibiotics and the other half antibiotics plus the friendly bacteria Lactobacillus, found in certain yoghurt brands. After a year, 80% of those who took Lactobacillus and the antibiotics reported their migraines had ceased. And only 50% of those on the antibiotic alone were better. Such results are encouraging, although not yet definitive.
Natural methods
One of the oldest nondrug approaches is the herb feverfew, long recommended by herbalists to prevent migraines. Fresh fever-few leaves are very bitter, so you might want to try standardised capsules or a tea. Just don't use fever-few if you're pregnant or if you're taking aspirin. Vitamin B2 (riboflavin) may help by boosting your brain's energy reserves. Good food sources include mushrooms, poultry and quinoa; it can also taken in supplement form.
Alternative therapies for migraine relief may be worth checking out. Biofeedback hooks you up to a small medicine that allows you to monitor your ability to regulate muscle tension and skin temperature, among other things. The relaxation techniques you learn can then be applied without the machine. Some people learn to raise their hand temperature, which draws blood away from the constricted vessels in the head that cause migraine pain. Those using biofeedback techniques report reduced frequency, severity and duration of attacks.
A session with a chiropractor, who uses techniques such as massage, spinal manipulation and adjustments to joints and soft tissues, can also provide relief for certain people. In addition, proponents of acupuncture say this ancient Chinese technique can help to relieve migraine pain by balancing serotonin levels and relaxing tense muscles.
The next group is the ergot derivatives. Ergotamine (Cafergot) has been around longer than the triptants and also works by constricting blood vessels. But it can nausea and vomiting. So your doctor may prescribe an antinausea drug to go with it. Methysergide (Deseril) is very effective but used only if other choices don't work; its side effects range from nausea, vomiting, abdominal pain, diarrhoea and depression, to a rare but potentially fatal lung fibrosis (excessive scar tissue). If pain relief continues to elude you, however, the next step is a powerful opiate, such as morphine, codeine or oxycodone (Endone, Proladone).
Less effective than prescription drugs and useful only for mild cases, nonprescription pain relievers include paracetamol (Panadol) and paracetamol and codeine combinations (Panadeine), and non-steroidal anit-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Naprogesic, Aleve) and ibuprofen (Nurofen). Other over-the-counter analgesis including dextropropoxyphene (Digesic, Capadex) and aspirin/codeine combinations (Codral Forte, Disprin Forte) can also be useful to provide itself.
There are also preventive medications to stave off migraines. Options include a daily aspirin; prescription beta-blockers, such as propranolol (Inderal), which provides long-term relief for about half of those with frequent migraines; calicum channel blockers, such as verapamil; tricyclic antidepressants, such as amitriptyline (Tryptanol, Endep) and nortryptiline (Allegron); and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Aropax).
HOW TO KEEP A MIGRAINE DIARY
Okay, it's time to play detective. The trench-coat and magnifying glass are optional, but pen and paper are required. The best way to idenify potential migraine triggers is to keep a diary of what happened immdiately before an attack. The information will be invaluable in helping you and your doctor figure out the best course of treatment for your headaches. Here's what you'll need to write down:
- The time that a headache started and stopped.
- Its severity (you should rate it on a scale of 1 to 10, with 1 being very mild and 10 being excruciating, debilitating pain).
- Any associated symptoms (nausea, vomiting, auras, sensitivity to light or sound).
- What you ate and drank throughout the day before the attack, especially any suspected triggers.
- Whether there was any change to your normal sleep pattern before the attack.
- Your stress level (on a scale of 1 to 10, with 1 being completely relaxed and 10 being totally frazzled).
- Medications and other actions you took and how long before significant relief occured.
Medications are not your only defence. When a migraine strikes, lie down in a dark room. Place an ice pack or gel pack wherever the pain is. A headband--either elastic or gel-filled (and cooled)--can also offer some relief. In addition, other lifestyle measures can minimise your attacks. The key is to identify and eliminate your triggers. Here's how:
Watch your diet. Many foods and drinks have been linked to migraines. Among the likely suspects are foods which contain nitrates (bacon, corned beef, ham, hot dogs, luncheon meats and sausage); the chemical MSG (monosodium glutamate); aged cheeses (Cheddar, Swiss, Stilton, Brie); chocolate; nuts; peanut butter; sour cream; caffeinated beverages; aspartame (aritificial sweetener); and alochol.
Eat regularly. Skipping meals is a common migraine trigger.
Get a good night's sleep. Too much or too little sleep can cause a migraine. Your best bet is to establish to consistent sleep pattern of seven to nine hours nightly. Keep in mind that changes to this pattern, including jet lag and broken sleep, can also trigger a migraine.
Exercise smart. Always warm up properly and ease into your workout, as it is thought that aerobic exercise can sometimes make migraines worse.
Cluster headaches
-------------------------------------------------------------------------------------------------------------------------------
This rare form of headaches strikes about 1 percent of people, and the overwhelming majority--are estimated 85 percent--are men. Its key symptom is distinctive: intense pain around one eye, lasting from 15 minutes to 2 hours. The name is descriptive. These headaches tend to come in clusters, occuring repeatedly (often at the same time of night) for several weeks or months. A common pattern is for the headache to attack a few hours after you fall asleep, during rapid eye movement (REM) sleep.
The cause of cluster headaches remains a mystery. Because cigarettes and alcohol are often triggers, heavy smokers and drinkers are at the greastest risk. While lying down may help relieve migraine pain, it can have the opposite effect on a cluster headache. Since the attacks are so short and intense, it's difficult for any drug to work quickly enough to help. In some people, breathing pure oxygen through a mask from an oxygen tank for about 10 minutes at the start of an attack provides the most effective relief. Because the headaches come in clusters, you best bet for preventive medication may be naratriptan (Naramig), which gives you long-term coverage.
- Relax. Stress can be another trigger, so take just a little time each day to sit quietly and relax your muscles. Teach yourself to let go of things you can't control.
A daily cup of yoghurt may help to prevent migraine headaches, according to Italian researchers. They estimated that 18% of chronic migraine sufferers are infected with the bacteria Helicobacter pylori, which has been linked to ulcers, heart disease and other health problems. The researchers split 130 people who had migraines and H. pylori into two groups, giving half antibiotics and the other half antibiotics plus the friendly bacteria Lactobacillus, found in certain yoghurt brands. After a year, 80% of those who took Lactobacillus and the antibiotics reported their migraines had ceased. And only 50% of those on the antibiotic alone were better. Such results are encouraging, although not yet definitive.
Natural methods
One of the oldest nondrug approaches is the herb feverfew, long recommended by herbalists to prevent migraines. Fresh fever-few leaves are very bitter, so you might want to try standardised capsules or a tea. Just don't use fever-few if you're pregnant or if you're taking aspirin. Vitamin B2 (riboflavin) may help by boosting your brain's energy reserves. Good food sources include mushrooms, poultry and quinoa; it can also taken in supplement form.
Alternative therapies for migraine relief may be worth checking out. Biofeedback hooks you up to a small medicine that allows you to monitor your ability to regulate muscle tension and skin temperature, among other things. The relaxation techniques you learn can then be applied without the machine. Some people learn to raise their hand temperature, which draws blood away from the constricted vessels in the head that cause migraine pain. Those using biofeedback techniques report reduced frequency, severity and duration of attacks.
A session with a chiropractor, who uses techniques such as massage, spinal manipulation and adjustments to joints and soft tissues, can also provide relief for certain people. In addition, proponents of acupuncture say this ancient Chinese technique can help to relieve migraine pain by balancing serotonin levels and relaxing tense muscles.
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