Migraines

Migraines

We are all susceptible to headaches, but migraines are a particular type of headache that is often recurrent and debilitating. The pounding pain and photophobia (sensitivity to light) associated with a migraine may mean you can do little more than lie in a darkened room.

Symptoms:

  • Throbbing that gets worse when you move.
  • Sensitivity to light.
  • Nausea.
  • Visual disturbances.
  • Poor concentration.
  • Feeling hot or cold.

What causes migraines?

Migraines are probably caused by changes in chemical levels in the brain. A drop in the chemical serotonin makes the blood vessels in the brain contract suddenly possibly causing the symptoms of aura (visual disturbances). When the blood vessels widen again this most likely causes the headache. Fluctuating hormones may also be linked to migraines which may explain why some women get an attack around the time of their period. Many people find their migraine is triggered by stress, tiredness, changes in temperature or by eating certain foods.

How are migraines treated?

People who have more than two attacks each month, or who respond poorly to treatment, may benefit from taking beta-blockers (known best as a treatment for high blood pressure or angina). A doctor can prescribe specific beta-blockers that act on the blood vessels in the brain. These may prevent migraine attacks if taken regularly.

If stronger treatments are needed ‘triptan medicines’ such as sumatriptan (available without prescription) may do the trick. These act on the blood vessels around the brain causing them to narrow reversing the widening that likely caused the headache. Triptans also help relieve nausea and reduce sensitivity to light and sounds. Sumatriptan is available as tablets, nasal sprays or as an injection.

Anti-inflammatory medicines such as ibuprofen can also be used to treat migraines. Ibuprofen is available without prescription. Stronger anti-inflammatory medicines such as Diclofenac, naproxen and tolfenamic acid are only available with an NHS or private prescription. Over-the-counter painkillers containing paracetamol or aspirin can also be effective. If painkillers are insufficient a pharmacist may recommend codeine or dihydrocodeine - these strong analgesics should not be taken for more than 3 days as they can cause addiction and make headaches worse if used longterm.

Adults who have three or more migraine attacks per month, or frequent migraine attacks that interfere with their daily life may be treated with a drug called topiramate (more commonly used to treat epilepsy). It’s thought the drug calms nerve activity in the brain.

Sometimes anti-sickness medicines are prescribed to treat migraines. There are also ‘combination medicines’ for migraine purchasable over-the-counter which contain both painkillers and anti-sickness medicines.

Alternative remedies & self-help:

  • Stress is a huge headache trigger so explore relaxation methods such as exercise and yoga. Establish a regular sleep pattern, drink plenty of water and avoid skipping meals.
  • Avoid triggers that you know to bring on a migraine such as certain foods.
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