Migraines typically are strong, pounding headaches on one or both sides of the head. They may be caused by the activation of nerve fibers in the blood vessels of the brain. Migraines typically include several other symptoms aside from the strong headache. These include sensitivity to light and sound, visual aura, nausea, vomiting, and fatigue.
According to the National Institute of Neurological Disorders and Stroke, roughly 12 percent of the U. S. population gets migraines. Any person of any age, class, sex, or ethnicity can get one.
Researchers believe that there are certain events, or “triggers,” that can lead to a migraine. These triggers are different for each person. There are several different types of medications and alternative treatments available to treat migraines after they have already started, but avoiding a migraine trigger is the best way to prevent a migraine from happening in the first place.
Prevention of a migraine is aimed at identifying and avoiding a particular thing that triggers your migraines. You can learn to do this by keeping a migraine diary for a few months.
You write down the following information in a migraine diary:
- what you ate and drank before the migraine, including if you drank water or alcohol that day and how much
- the time the migraine started and when it ended
- what events happened before the migraine and what you did that day
- how you were feeling around the time the migraine started
- what medications you took and how much
- the proximity to the onset of menses (females)
It will be much easier to figure out whether or not your migraine attacks are related to something you do, eat, drink, or experience if you keep a migraine diary. For example, if you have a meal high in monosodium glutamate (MSG) or salt prior to each migraine, you could avoid meals high in MSG or salt.
According to the Institute for Quality and Efficiency in Health Care, some of the most commonly reported food and beverage triggers for migraines include:
- alcohol (particularly red wines)
- dairy products, like milk and yogurt
- artificial sweeteners like aspartame
- aged cheeses
- caffeine withdrawal
- flavor enhancers like monosodium glutamate (MSG)
- other food additives
Other events or situations that could trigger a migraine include:
- warm weather
- bright lights, including sunlight
- loud sounds
- change in weather patterns
- intense physical exertion
- lack of sleep
- smoking and tobacco
- strong odors, such as perfume, paint thinner, or secondhand smoke
- birth control pills and hormone replacement therapies
According to a 2008 Brazilian study, fasting (not eating for long periods of time) was the most commonly reported migraine trigger. Alcohol, chocolate, and caffeine were the most common dietary substances associated with a migraine attack. Red wine was a frequent trigger among women.
Avoiding these triggers can be the key to preventing your migraines and improving your overall quality of life.
In addition to avoiding triggers, lifestyle changes are also important for preventing a migraine. You can do the following to help prevent a migraine:
- exercise regularly
- maintain a healthy weight
- reduce your stress levels
- use muscle relaxation techniques like meditation or yoga
- get an adequate amount of sleep each night
- sleep and eat meals on a regular schedule
- drink plenty of water
Some people continue to suffer from frequent migraines even after making serious attempts to identify or avoid triggers. You should talk to your doctor about taking migraine or pain medications if this is the case.
Some medications are available over the counter. Others require a prescription. The choice of medication depends on several factors. These may include having a co-existing medical condition, the frequency of your migraines, and side effects of the medications.
There are medications that are taken regularly in order to prevent migraines. These include:
- anticonvulsants (anti-seizure drugs), such as valproate sodium (Depacon), topiramate (Topamax), or gabapentin
- tricyclic antidepressants, such as amitriptyline (Elavil)
- antihistamines, such as cyproheptadine
- beta-blockers, such as propranolol (Inderal) and timolol (Betimol), among others
- anti-inflammatory drugs, such as naproxen (Naprosyn)
- Botulinum toxin A (Botox) is a toxin secreted by a bacterium that has been used for years to treat muscle contracting disorders and is commonly known for its ability to treat wrinkles. Botox was approved in the United States to prevent migraines in 2010. To treat migraines, Botox is injected into muscles of the forehead and neck and usually only needs to be repeated every three months.
There are also medications available to treat an attack that has already started:
- Pain-relieving medications such as analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Motrin) or drugs marketed specifically for migraines such as Excedrin Migraine.
- Triptans, including sumatriptan (Imitrex) and frovatriptan (Frova).
- Ergots, including ergotamine and caffeine combination drugs such as Cafergot.
- Anti-nausea medications, which are usually combined with other medications.
Nontraditional or alternative treatments may be helpful for people who suffer from chronic migraines. They are aimed at relieving migraine pain. Alternative therapies include the following:
- acupuncture: a therapist skilled in acupuncture inserts thin needles into certain defined points in your skin
- biofeedback techniques: a relaxation technique that helps you learn to control physical responses related to stress and muscle tension and pain; once you learn the techniques, they can be practiced anywhere
- herbal products, including butterbur and feverfew, have been shown (with mixed results) to prevent or reduce the severity of migraines
- vitamins such as riboflavin (vitamin B2), magnesium, and coenzyme Q10
Talk to your doctor before attempting to use an herbal or vitamin supplement for your migraines. Don't use feverfew, riboflavin, or butterbur if you're pregnant.
Many people who suffer from migraines learn from experience what needs to be done to get through a migraine attack. They may lie down in a dark room, take a nap, or apply cold packs to their forehead. Sometimes that’s enough to treat their migraine.
For others, however, migraines are more difficult to control or prevent and happen too often. Talk to your doctor about which treatment is right for you if you’re experiencing frequent migraine attacks. Medications, in combination with lifestyle changes and avoidance of migraine triggers, may be the key to treating your migraines.