Several medications were recently deemed the most effective for treating acute migraine, including triptans, dihydroergotamine (DHE), nonsteroidal anti-inflammatory drugs (NSAIDS), butorphanol nasal spray, and the combination medication of sumatriptan/naproxen and acetaminophen/aspirin/caffein). Several other migraine medications were considered "probably effective" or "possibly effective."

Relief for people who suffer from chronic migraine may be derived from the hormone oxytocin, according to information presented at the International Headache Congress during June in Boston. In the study of 40 participants, those who received an intranasal dose of oxytocin reported significant pain relief from 2 to 4 hours later. Sixty-four percent who were treated with the hormone reported a substantial decrease in pain compared to 27% of those who received a placebo. 

Q. Is there anyone out there who gets vacation migraines? My world is pretty stressed. With working out of town, crazy sleep schedules, and taking care of my elderly mother-in-law, I live at a pretty high level of stress all the time. I do have chronic migraines, but I seem to get headaches when we go on vacation or at least the first part of the vacation. My husband tries to keep my stress low when we go on vacation, but I still get the headaches, even without the stress of day-to-day life. Is it because of the change in hormones at the lack of stress? Is it the drastic change that gives me the headaches?

Q. I have had migraines for more than 30 years and am successfully managing with them with abortives. Until recently they were mainly without aura, but lately I have been getting several auras a week, but without a headache. Can you explain what is happening and provide any suggestions for treatment?  I also get scalp pain that sometimes progresses to a headache and sometimes not. I usually treat that with a non-steroidal anti-inflammatory medication. I would appreciate any comments or suggestions you have on either of these issues.

Researchers from two hospitals in Italy have been studying what they call "airplane headache" (AH) and recommend that the disorder be included in the next update to the International Headache Society classification. Such a move, the authors say, would bring more studies and better understanding of AH and how it might be prevented. In recent years, these authors have followed 75 people who contacted them about experiencing AH and have developed a profile of the painful disorder.

Q. I have had a kidney removed due to cancer. Consequently, I've been told to avoid nonsteroidal anti-inflammatories (NSAIDs) and other pain relievers that are metabolized through the kidneys so as to not stress the remaining kidney. Acetaminophen no longer provides any relief for my migraines. The triptans work, but always result in a bad rebound headache about 20 hours later. Are there any acute medications for migraine, other than the triptans, that are not metabolized through the kidneys? I have 9 to 11 days a month of migraine and have not found a preventive medication that works.

While more people are being treated for migraine and severe headaches than ever before, many of them are not getting appropriate medications for their condition. According to a study that assessed trends in prescribing medications, more opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, muscle relaxants and barbiturates are used than in the past even though more migraine-specific medications are now available. Opioids and barbiturates particularly raise concerns because they're linked to an increased risk of chronic daily headache.

Migraineurs often suffer from additional health problems (called comorbid conditions) and these can include gastrointestinal disorders. One recent study found that gastroesophageal reflux disease (GERD) is common among migraine patients. It also found that those patients frequently take nonsteroidal anti-inflammatory (NSAID) medications to control their migraines.