PHYSICIAN VOICES
What I Wish My Patients Knew About Treating Migraine

woman-with-hand-on-head-with-doctor-in-background
Getty

There are many things that are important for patients to know about migraine.

By understanding key concepts about migraine, you can better help your doctor find the right treatment for your migraine.

Get the Right Diagnosis

Every bad headache is not the same as a migraine, and should not be treated as such. That’s why it’s so important to get a diagnosis from your doctor. A three item migraine screener, known as ID Migraine, is a reliable tool for migraine recognition. These screening questions identify:

  • nausea
  • disability
  • sensitivity to light

You can help your doctor diagnose migraine by keeping a headache diary using the migraine screener as a guide. Migraine episodes usually have a trigger, and identifying it is beneficial for developing an effective treatment plan. A good headache diary should include date, time, duration, intensity, triggers, preceding symptoms, treatment used and response to that treatment.

Find Effective Treatment

More than one medication may be needed to manage migraine episodes. There are some medications that will quickly help relieve symptoms, and that may be the only remedy necessary to manage your migraine. However, others may need a monthly injection or a pill that they take daily to help prevent migraine episodes, and in the event one does occur, they will still have to take another medication to get rid of it.

Triptans are a type of a medication that is used in moderate to severe migraine episodes. You may have to take more than one brand of triptan to get rid of a migraine headache. Many patients express frustration when the first triptan they try is not effective, and they may feel as if their migraine will never resolve. However, the doctor may switch the brand of triptan and if that is not effective, other therapies may be considered.

There are other ways to manage migraine episodes that may not necessarily require one to take medication by mouth. Botox has been found to decrease the frequency of headaches in individuals with chronic migraine episodes. CGRP blockers like erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality), and eptinezumab-jjmr (Vyepti) are a class of migraine prevention drugs, and they block a molecule thought to instigate and intensify migraine episodes. A monthly or quarterly self-injection or infusion of one of these drugs can reduce migraine frequency by half for some people. Studies have shown that acupuncture is beneficial in migraine prevention, as well. Triptans that can be taken nasally have proven effective in children and adolescents, but those treatments are not generally recommended by drug manufacturers or FDA-approved for use in the pediatric population. Cognitive behavioral therapy (plus the use of a preventive medication) is a good means of treatment in this population.

Additional treatment options include calcitonin gene-related peptide (CGRP) antagonists and nonsteroidal anti-inflammatory drugs (NSAIDS).

Migraine affects everyone differently, so it’s important to understand the nuances of your headaches. The more you know, the more likely it is that you and your doctor will find treatments that offer you relief.  

Was this helpful?
43
View All Migraine and Headache Articles
THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.