There are two main strategies to treat migraine headaches with medication. The first is what is known as ‘abortive’ therapy and the second is known as ‘preventive’ or ‘prophylactic.’
Abortive therapy is how most people think about dealing a headache. You take some kind of pain reliever to try and stop or abort the headache. This may range from over the counter products as acetaminophen (Tylenol) or ibuprofen to prescription products such as Fioricet, sumatriptan (Imitrex) or Cambia. These are all excellent products for people who have an occasional or rare headache.
However, using these medications on a regular basis, can lead to either the medication becoming less effective over time. Sometimes, when the medications are taken frequently, they can even cause headaches, in a syndrome known as “analgesic (pain killer) overuse headache.”
Generally, when a person typically has more than four headache days per month, physicians like to prescribe medication that is taken on a daily basis to help prevent the headache from coming in the first place. There were no medications specifically created to prevent migraine headaches; instead physicians prescribe compounds belonging to one of a few different classes. These are
|Blood pressure||Propranolol or verapamil|
|Anticonvulsant||Topirimate or valproic acid|
|Antidepressant||Amitryptiline or nortriptyline|
When prescribed appropriately, these medications can be quite effective. However, some of these medications do require monitoring and may have side effects (weight gain or loss, sleepiness, confusion, constipation). It is important to use any of these medications under the care of a physician experienced in the care of migraine headaches.
Many people prefer not to take prescription medications or are sensitive to their effects. For people with regular headaches who need treatment, physicians may suggest more ‘natural’ or ‘complementary’ alternatives.