20 Preventive Therapies (Prophylaxis) for Migraine Headaches?

1. – Triptans:

Triptan drugs are the most effective therapies for migraine headaches, which include many different types of medications including naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), zolmitriptan (Zomig), eletriptan (Relpax), etc. These drugs are available as tablets, nasal sprays, and also dissolving sublingual tablets. Only Sumatriptan is available as an injection form.

2. – Anti-emetics:

Sometimes the headache pain can be severe enough to cause nausea or vomiting occurs before or during a migraine attack. It may be to treat these symptoms with anti-emetic drugs. These include Ondansetron (Zofran), Prochlorperazine, Chlorpromazine.

3. – Anti-inflammatory Drugs: 

Aspirin is often used for mild cases of migraine headaches, But it has no value for preventing or aborting a migraine. Other anti-inflammatory drugs available with few side effects are Celecoxib (Celebrex), naproxen (Naprosyn), etc.

4. Prevention Is Better Than Cure:

Among the preventive therapies, some drugs are usually prescribed when attacks of migraine headache occur frequently or when they interfere with daily activity. For this purpose you need to consult your internist or family physician to prescribe you one of the following:

5. More Than One Drug:

Some people with migraine headaches may need to take more than one drug at a time such as Triptan and anti-inflammatory medicine like naproxen, aspirin or Ibuprofen, or Acetaminophen. It may be necessary to take triptans for 1-2 days before the menstruation cycle to avoid menstrual migraines.

6. Avoid Triggers:

For many migraine sufferers, avoiding known triggers can help reduce their frequency and severity of attacks. Things such as stress, diet changes, lack of sleep, hormonal changes, and weather changes can be avoided to reduce attacks.

7. Acupuncture: 

Acupuncture which involves inserting thin needles into specific points in the body that are believed to cause disease or pain is used along with headache medicines for migraine treatment. However, it has not been shown to prevent migraines but it can help reduce their severity and frequency.

8. Herbal Remedies:

For centuries people have been using herbal remedies for treating numerous health conditions. The herb feverfew is available in fresh or dried leaves grown in North America which are used in the prevention of migraine headaches. It contains parthenolide that may reduce inflammation around blood vessels known to cause migraine attacks.

9. Biofeedback:

It is a meditation practice to use breathing rate changes, muscle relaxation, and skin temperature measurements for reducing stress. This therapy involves the patient learning how their body’s functions are related to mental activity by becoming aware of these activities through various techniques over some time.

These include measuring the electrical resistance in their skin, blood pressure, or heart rate at different times before and during training. Patients are then taught how they can control some of these responses by relaxing certain muscles, slowing down breathing, or using other self-control methods that are used daily at home until they have mastered control over them.

10. Avoid Triggers :

The most important way to prevent future Migraine Headaches is to avoid or eliminate known triggers that you think maybe cause your Migraines.

11. Headache diary:

Keep a headache diary to help you identify what factors might trigger your migraine attacks. Note down the time, duration, and severity of each attack as well as any activities you were engaged in at the time, how much sleep you had before an attack, what medication was used during it, how long it lasted, and other relevant information about anything unusual happening around the same time.

12. Triptans:

Triptan is available for the treatment of severe migraines which are resistant to other therapies like NSAIDs ( Ibuprofen, Acetaminophen) or anti-emetics (Ondansetron, Metoclopramide). Triptans are serotonin receptor agonists believed to relieve pain during migraine attacks .

They can reduce the number of days with migraine during a month and they also provide improvement in disability compared with placebo after 3 months of treatment. However, these drugs do not prevent migraines but can be used for short-term prevention when taken daily at the time of the expected headache onset.

13. Antidepressants:

The tricyclic antidepressant drug Amitriptyline has been shown to treat recurrent chronic Migraine Headaches. It is an inexpensive alternative to triptans or ergots for this purpose.

14. Avoiding Triggers :

People with frequent migraine headaches usually find it helpful to keep a diary listing the known triggers and to avoid them as much as possible to prevent future attacks.

15. Massage:

Massage therapy involves a range of techniques that include kneading, tapping, rubbing, or striking movements to affect the soft tissues in your neck, back, and other parts of your body to ease muscle tension and pain. It is helpful for chronic Migraine Headaches but only when combined with medication or other therapies.

16. Beta-Blockers :

Beta-blockers are used for preventing migraines due to the reduced flow of blood from arteries supplying blood to the brain region causing a migraine headache. The drugs also block some neurotransmitters important in causing a migraine headache including serotonin, histamine, and norepinephrine. Drugs such as Propranolol, Atenolol, Nadolol, and Timolol are commonly prescribed for treating migraine headaches.

17. Spinal Manipulation :

It is the noninvasive physical manipulation of the spine or other joints in your body with slow gentle pressure to improve your range of motion and ease the pain. It may be used alone or combined with medication to treat migraines.

18. Acupuncture:

This therapy involves placing thin needles into certain areas on your skin at various depths to stimulate certain pathways that help relieve pain. There is evidence it can prevent future Migraine attacks when performed with moderate frequency (2-3 times monthly) which reduces the number of days with migraine during a month without compromising the quality of life.

19. Biofeedback:

This helps you to learn how to control some of these responses by relaxing certain muscles, slowing down breathing, or using other self-control methods that are used daily at home until they have mastered control over them. Some people find this type of therapy helpful for treating migraines.

20. Relaxation Therapy:

Relaxation is a state of physical and mental calmness which can be achieved with help of relaxation training. This therapy may reduce frequency or severity or both for some people who have migraines.

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