Treatment of Migraine

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Most people find that sleeping or lying in a darkened room is the best thing to do when having a migraine attack. Others find that eating something helps, and others start to feel better once they have been sick.

Medication to treat symptoms of migraine

See your GP about your migraines. There is a range of migraine medication available. Taking the medication very early in the migraine attack is best because the stomach is not easily able to absorb tablets during a migraine.

Painkillers such as paracetamol or aspirin are effective in many cases, together with an anti-sickness drug such as metoclopramide (not generally recommended for children) or domperidone. Some tablets used for migraine attacks contain both; Migraleve contains paracetamol and codeine. These drugs may not suit everyone, so speak to your GP or pharmacist if you are unsure.

Some people find NSAIDs (non-steroidal anti-inflammatory drugs) are effective. They relieve swelling, pain and inflammation. They include ibuprofen (which is available over the counter) and naproxen, diclofenac potassium and tolfenamic acid (for which you need a prescription).

Effervescents (dissolvable tablets) are used by people who cannot keep tablets down. Injections, nasal sprays, wafers or suppositories (soft capsules that you insert into the vagina or anus) are other options.

Drugs called triptans (or 5HT1 agonists) are used to relieve the symptoms of migraine. Triptans make the blood vessels in your brain narrower, which can stop your brain from feeling the pain of migraine, at least partly. You may have to try more than one triptan before finding one that suits you. They include eletriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, almotriptan, and frovatriptan. Take them at the start of the headache stage, not before (not during the aura stage). Side effects of these drugs can include sickness, dizziness, nausea, vomiting, neck pain and stiffness, and a sensation of heaviness or pressure anywhere in the body. They should be avoided if you are over 65, or have a history of heart disease, stroke or high blood pressure (hypertension).

If your migraine are severe and do not respond to other treatment such as painkillers, your GP may suggest a drug such as eergotamine tartrate. This should not be used if you have kidney problems, heart or circulatory disease, high blood pressure or are pregnant or breastfeeding.

Medication to prevent migraine

There are drugs available that can reduce the frequency and severity of your migraines. You have to take the medication every day and can still take painkillers or triptans when you get a migraine. You will need to speak to your GP about what medication will suit you best because some drugs have side effects. Drugs that can help to prevent migraine include:

beta blockers, such as propranolol (people with asthma cannot take these),
pizotifen (these can cause weight gain and drowsiness so are usually taken at night), and
antidepressants, such as amitryptyline.

Migraine mediation and the combined contraceptive pill

Fluctuating oestrogen levels can make migraine worse. If you take the combined contraceptive pill and suffer from migraine, you may be advised to change to the progesterone only pill. If you have â€˜classicalâ€™ migraine, with the preliminary aura stage, you should not take the combined contraceptive pill, due to the increased risk of a stroke.