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What Are the Different Types of Headaches?
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Pharmacological Approaches to Preventing and Treating Migraine Attacks
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Living with Migraine
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Non-Pharmacological Approaches to Migraine Prevention
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Talking to Your Doctor About Migraines
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 play videoTime: 06:53 minutes |
Webcast Transcript
RICHARD LIPTON, MD: When people keep a headache diary, typically, I ask them to record when the headache began, how long it lasts, what they took for it, whether the medication worked. And then I ask them to think back about the 24-hour period prior to headache onset to see if they can identify a factor that may have triggered the headache.
ANNOUNCER: There are also medications that might prevent attacks.
RICHARD LIPTON, MD: Those include beta blockers like propranolol or Inderal and calcium channel blockers like verapamil or Calan. In addition, antidepressants are sometimes used to prevent migraine attacks as well.
The new class of compounds for migraine prevention are called neuromodulators. There's an idea which I think is correct that people with migraine have a sensitive or excitable brain and what neuromodulators do is reduce the excess electrical activity in the brain.
ANNOUNCER: And some feel relaxation techniques can also help.
RICHARD LIPTON, MD: Stress management plays a role, particularly in people for whom stress is a trigger, so biofeedback and cognitive-behavioral therapy are really quite useful.
ANNOUNCER: But when a migraine strikes, there are ways to manage the pain. And the answer could be as close as your morning cappuccino.
RICHARD LIPTON, MD: Caffeine is well known to relieve migraine headaches and is a common component of combination of ingredient products that are used for migraine.
ANNOUNCER: Caffeine can constrict blood vessels which become inflamed during a migraine. So don't decide to suddenly go cold turkey on coffee.
RICHARD LIPTON, MD: Caffeine withdrawal can be a powerful trigger of migraine and caffeine withdrawal is a major cause of weekend headache in people who sleep through their morning cup of coffee. What I recommend to patients is that they limit their use of caffeine on most days to just one cup of coffee a day, but that they use caffeine, if it's effective for them, as a headache comes on, either in combination with a painkiller or in combination with whatever they're taking to relieve their headache.
ANNOUNCER: Yes, painkillers. There is a high likelihood that you'll be needing one of those.
RICHARD LIPTON, MD: The nonspecific treatments are aspirin, acetaminophen, nonsteroidal antiinflammatory drugs like ibuprofen which gets sold as Advil or Motrin and then combination medications which may include caffeine, may include sedatives, may include other compounds.
On the specific treatment side, the mainstay of acute migraine treatment is now a class of compounds called the triptans.
ANNOUNCER: Getting control over a migraine can mean finding a way to regain control over your own life.
RICHARD LIPTON, MD: The sort of underlying purpose is to give people the tools they need so they can manage their headaches rather than having their lives run by their headaches.
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