Migraine Headache Health Article

Expected results

Most people can control migraines through recognizing and avoiding triggers, and by using effective treatments. Some people with severe migraines do not respond to preventive or drug therapy. Migraines usually wane in intensity by age 60 and beyond.

Prevention

The frequency of migraine headaches may be lessened by avoiding triggers. It is useful to track these triggers by keeping a headache journal.

One substance that is being studied as a possible migraine preventive is coenzyme Q₁₀, a compound used by cells to produce energy needed for cell growth and maintenance. Coenzyme Q₁₀ has been studied as a possible complementary treatment for cancer. Its use in preventing migraines is encouraging and merits further study.

A study published in early 2003 reported that three drugs currently used to treat disorders of muscle tone are being explored as possible preventive treatments for migraine. They are botulinum toxin type A (Botox), baclofen (Lioresal), and tizanidine (Zanaflex). Early results of open trials of these medications are positive.

Anti-epileptic drugs, which are also known as anti-convulsants, are also being studied as possible migraine preventives. As of 2003, sodium valproate (Epilim) is the only drug approved by the Food and Drug Administration (FDA) for prevention of migraine. Such newer anticonvulsants as gabapentin (Neurontin) and topiramate (Topamax) are presently being evaluated as migraine preventives.

A natural preparation made from butterbur root (Petasites hybridus) has been sold in Germany since the 1970s as a migraine preventive under the trade name Petadolex. Petadolex has been available in the United States since December 1998 and has passed several clinical safety and postmarketing surveillance trials.

Other possible preventive measures include: eating at regular times, not skipping meals, reducing the use of caffeine and pain-relievers, restricting physical exertion (especially on hot days), and keeping regular sleep hours, but not oversleeping. Other measures include:

• Aerobic exercise, which can reduce the frequency of migraines.
• Biofeedback thermal control was found to be as effective as medications in preventing migraines.
• Celery juice consumed twice daily may help to prevent migraines.
• Feverfew was shown to reduce the severity and frequency of migraines. This herb should not, however, be used during pregnancy or by people taking blood-thinning medications.
• Ginger may help prevent migraines.
• Pulsing electromagnetic fields. A preliminary study found that pulsing electromagnetic fields reduced the frequency of migraines.
• Relaxation techniques can reduce migraine frequency.
• Supplementation with magnesium and riboflavin was shown to prevent migraines.

BOOKS

American Council on Headache Education. Migraine: The Complete Guide. New York: Dell, 1994.

"Migraine. " Section 14, Chapter 168 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part II, "CAM Therapies for Specific Conditions: Headaches." New York: Simon & Schuster, 2002.

PERIODICALS

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