Migraine occurs approximately three times more frequently in women than men. The exact reason(s) for this difference is not completely understood, but hormone fluctuations are considered to be a main culprit. Approximately three out of four women with migraine experience attacks that correspond to their menstrual cycle or endure their most severe attacks during this time.
Menstrual migraine typically occurs in a predictable pattern. Headache diaries are useful for discerning this pattern, which is necessary for diagnosis and to time treatment appropriately. Once menstrual migraine is confirmed, drug treatments can be taken in an anticipatory manner to help maximize their ability to reduce or eliminate migraine pain and associated symptoms.
All questions are answered by:Richard Wenzel, PharmDDiamond Headache Clinic Inpatient UnitSt. Josephýs Hospital, Chicago, IL
Perhaps more than any group of medications, the triptans have contributed to the improved recognition and treatment of migraine and other types of headache. Introduced in the United States in 1993, these drugs have been an important catalyst for research, advanced healthcare professionalsý understanding of migraine, and offered an effective drug option to halt attacks, all of which ultimately benefitted thousands of migraine sufferers.
There are now seven triptans available in the U.S. The triptans appear to act in migraine by binding to selected receptors for serotonin found in the blood vessels (5HT1B) and nerve endings (5HT1D). By binding to these receptors, triptans keep migraines from developing or cause them to end.
All questions answered by:Richard Wenzel, PharmD
Diamond Headache Clinic Inpatient Unit
St. Joseph’s Hospital, Chicago, IL
Approximately 15 million migraine sufferers exclusively use over-the-counter medications to treat their illness. This preference for OTC drugs results from several factors, including the ease of purchasing OTC products, their low cost (especially in comparison to prescription drugs), and their generally wide safety margin. While many patients successfully treat their migraine attacks with OTC agents, a significant proportion of sufferers fail to obtain adequate relief from these medications.
Q. Ever since having a baby I have been experiencing an average of one migraine attack per week. For home use, I was given Migranal (dihydroergotamine nasal spray). Last night I had to take the Migranal for the first time and much to my disappointment got little relief. Is this a drug that takes a couple of uses before it works? I sometimes wait until my headache is really bad before using drugs. Was I just too late in the headache for the medication to be effective?
Q. I'm a cluster sufferer and often use injectable sumatriptan pens several times daily during my worst bouts. It's the only thing that works. But my local pharmacy and my insurance company give me grief about the amount of sumatriptan I use, meaning I have to pay out of my own pocket. Am I using too much sumatriptan?
All questions answered by:Rich Wenzel, Pharm.D.Diamond Headache Clinic Inpatient UnitSt. Joseph’s Hospital, Chicago, ILQ. My migraine attacks are becoming more frequent, so my doctor prescribed topiramate (Topamax®). I have taken birth control pills for many years and I just read that topiramate may cause a negative interaction. Is this true?
Questions answered by:Rich Wenzel, Pharm.D.Diamond Headache Clinic Inpatient UnitSt. Joseph’s Hospital, Chicago, ILQ. My migraine attacks are becoming more frequent, so my doctor prescribed topiramate (Topamax®). I have taken birth control pills for many years and I just read that topiramate may cause a negative interaction. Is this true?