Q. I have been dealing with migraines that I inherited from my mother, who got them from her mother, for almost 20 years now. I lose a week of my life every month when I get my menstrual cycle. I've been looking for a way to prevent this without the use of birth control pills because they only seem to aggravate my condition. When I was pregnant with my son, the second half of my pregnancy was incredible. I had no headaches and never felt better. I should also add that once my mother and grandmother went through menopause, their headaches disappeared. Is there anything that you could recommend? I seem to do pretty well the rest of the month due to some dietary changes I've made over the past year.
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."
Q. I'm starting to notice a couple of changes with my migraines and wonder if these are common. One is that I am getting mini-cluster headaches once or twice a day, 2 or 3 days before a big migraine attack, and the other is nausea with no migraine pain. I typically get the nausea after the migraine pain has begun, but is it possible it can switch?
According to a recent study, using a screening tool that asks if a patient experiences headache disability, nausea, and sensitivity to light can help diagnose migraine and decrease opiate prescriptions.
Q. I have had chronic daily headaches and migraines with aura for years. I also have fibromyalgia, TMJ (temporomandibular joint syndrome) disorder and irritable bowel syndrome (IBS). All of these involve chronic pain. I take Relpax® for the migraines, which helps a lot with the aura and works okay for the headache. I also take Cymbalta® for depression, but haven't noticed any pain relief from it. The only other medication I seem to tolerate is Advil®. Since I have a headache “24-7”, with no beginning or ending, I never really know what causes it. How many pain relievers (like Advil) do you have to take to get a rebound headache? I never take more than two a day, but I wonder if taking them for several days makes my headache worse. I want to do anything I can to prevent an already difficult situation from getting worse.
Q. I get three to four migraines per month, sometimes with aura, sometimes without. I find that my biggest triggers are my menstrual cycle and stress. Given this, which medication is more effective for migraine prevention: beta blockers or calcium channel blockers?
The high blood pressure medication candesartan (Atacand) appears to be as effective as the more commonly prescribed medication propranolol (Inderal) in preventing migraine attacks.
Many doctors already prescribe candesartan for migraine prevention, but researchers from St. Olav’s Hospital in Trondheim, Norway, and the Norwegian University of Science and Technology recently conducted a study to provide proof that the medication works.
The throbbing quality of migraine pain many not result from changes in blood vessels as previously thought, but rather from brain waves.
Experts have long believed that the throbbing quality of pain is related to arterial pulsations and the rhythm of the heart. However, a team of researchers has shed new light on the “vascular” idea, which dates back to the days of Aristotle.