Today there are more treatment options available for people who suffer from migraine than ever before. As a result, people with migraine are now better able to manage their symptoms due to the variety of therapies available, whether through drug or non-drug treatments. In terms of medication, there are currently two main types available, which are preventive and abortive. Preventive migraine medicines are used to help prevent acute attacks, while abortive migraine medications can be helpful in stopping attacks when they occur. In this article we will discuss both of these types of migraine medicines in detail, in addition to alternative non-drug therapies that can also be helpful in alleviating or preventing the occurrence of migraine symptoms.
Different types of preventive migraine medications are prescribed which can help to prevent or reduce the severity and number of attacks. Anticonvulsant drugs, such as gabapentin (Neurontin), Divalproex Sodium (Depakote), and topiramate (Topamax) can help reduce the frequency of migraine episodes. Tricyclic antidepressants such as amitriptyline have demonstrated efficacy for some people in reducing the frequency of migraine attacks as well. Cardiovascular medicines that are commonly used to treat high blood pressure are another treatment option that can help prevent migraine episodes and reduce their intensity. Drugs in this class include beta-blockers such as propranolol and metoprolol, calcium channel blockers such as verapamil, and ACE inhibitors (American Migraine Foundation, 2016). The CGRP monoclonal antibodies are a newer type of migraine specific medication that have been recently approved by the FDA. The first medication in this class was approved in May of 2018; erenumab (Aimovig). Erenumab is unique in that it binds to the CGRP receptor to prevent migraine symptoms. The FDA has recently approved two additional CGRP monoclonal antibodies that bind to the CGRP neuropeptide. These medications are fremanezumab (Ajovy) and galcanezumab (Emgality) which bind to the neuropeptide to prevent the expression of migraine symptoms. They are specifically designed preventive medications for the treatment of migraine, unlike the previously discussed preventive medicines that were developed for other conditions initially (Remedy Health Media, 2018).
Several types of abortive migraine medications can be useful in halting a migraine attack once it has started. Triptans were designed specifically to halt acute migraine attacks. Drugs in this class include sumatriptan (Imitrex), zolmitriptan (Zomig), rizatriptan (Maxalt), eletriptan (Relpax), and others. There is a concern at the present time that people who have a history of cardiovascular issues should not take a triptan drug, as this can increase their risk of a coronary event. Analgesics are abortive migraine medications that include nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, aspirin, and acetaminophen (Remedy Health Media, 2018).
As an alternative to drug therapy, there are non-drug treatments which can be helpful in stopping or preventing a migraine episode in some people. One of these treatments is a device known as SpringTMS, which generates magnetic pulses in the brain to reduce or prevent migraine attacks. Another non-drug treatment device is gammaCore, which sends mild electrical stimulation to the vagus nerve to improve the symptoms of migraine attacks (Remedy Health Media, 2018).
It is important to seek out treatment with a qualified healthcare professional if you have or suspect migraine, as there are many different types of treatments which can potentially relieve symptoms and improve quality of life.
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American Migraine Foundation. Preventive Treatments. (2016, November). Retrieved November 3, from https://americanmigrainefoundation.org/understanding-migraine/preventive-treatments/
Remedy Health Media, LLC. All About Therapies. (2018). HealthCentral Migraine, 8-11.