Am Fam Physician. 2002;66(11):2140-2141
What are migraines?
Migraines are headaches. They affect millions of people. The pain of a migraine ranges from moderate to severe and throbbing. The pain may be limited to one side of the head. There is usually nausea and sometimes vomiting. People with a migraine headache try to avoid lights, sounds, and smells.
Many things can trigger a migraine headache, such as hormone changes, certain foods or smells, hunger, and tension relief after stressful events. Keeping a headache diary can help you identify your triggers.
How can my doctor tell that my headache is a migraine?
Not all headaches are migraines. Usually, your doctor can tell that your headache is a migraine by asking you specific questions and giving you a good exam. Sometimes, your doctor may have you get special x-rays or other tests to help make the diagnosis.
How is migraine headache treated?
Many different treatments are available. It is important to find the treatment that works best for you. If your headaches are frequent, your doctor may try to reduce the number of headaches you have. This is called preventive treatment.
Another kind of treatment stops a headache when it starts, so it doesn't get really bad. This is called pain-control treatment.
Some people with migraines have to take medicine every day to prevent headaches. They might take other headache medicines too if they feel a headache starting.
What about the headache pain I'm having right now?
The pain of a migraine headache can keep you from enjoying your life. But many pain-control medicines can get you back on your feet quickly and without side effects. Your doctor may ask you to try aspirin or anti-inflammatory medicines like ibuprofen or naproxen. You might try combination medicines like aspirin plus acetaminophen plus caffeine, or isometheptene combinations. Or you might try medicines called ergotamines or triptans. Any of these medicines may work for your headache.
You may need to try several kinds of medicines to see which ones work best for you. Your doctor will want you to use the least amount of medicines to treat your migraines.
What are the “triptans”?
Triptans are a kind of medicine. They work on the cause of the migraine. They usually help the other symptoms that come with the headache, too. Triptans can be very effective but are not right for everyone. If you have heart disease or severe high blood pressure, they may not be the right medicine for you.
Triptans can be taken in many ways. While most come in pills, there are also other kinds that are injected under the skin, sprayed into the nose, or dissolved on the tongue.
You may have side effects from triptans. The common side effects include increased heart rate, dizziness, and chest pressure. Your doctor may ask you to try one of these medicines for two or three headaches to see if it helps you. If it doesn't, your doctor may have you try another kind of triptan.
What else can I do?
The National Headache Foundation recommends that you and your doctor follow these 10 steps to develop a successful treatment program. A more detailed explanation of these 10 steps can be found on the World Wide Web at www.headaches.org, or you can get information by calling 1-800-843-2256.
Ask for help. Be a self-advocate.
Educate yourself about migraines so you'll know what to tell your doctor about your headaches.
Visit your doctor just to talk about your headaches.
Get ready for the visit with your doctor by keeping a headache diary for a few weeks before the office visit.
Have reasonable expectations about treatment. No one can cure migraine headaches.
Tell your doctor about all the medicines you take (including herbal medicines) and other medical conditions you have.
Focus on solutions. Be positive.
Ask for detailed directions for taking your medicine. Then follow the directions.
For treatment success, be a partner with your doctor.
Keep in touch with your doctor.
Where can I get more information about migraines?
For more information, you can visit the following Web sites:
National Headache Foundation (www.headaches.org)
American Council for Headache Education (www.achenet.org)
Migraine Disability Assessment (MIDAS) Web site (www.midas-migraine.net)