About the Treatment of Migraine

Treatment

The treatment of migraine has advanced greatly over the past 20 years with the development of triptans and new preventive medications. Because migraine symptoms and the degree of impairment vary from patient to patient, it is important to choose the most appropriate treatment method for each individual.

1. When to seek medical care immediately Even if you usually have headaches, you should go to the hospital immediately if the pattern of your headache changes or if it suddenly feels different. If you have any of the following symptoms, they may be warning signs of a dangerous condition, so go to the emergency room immediately.

· A sudden, severe headache like a lightning strike · High fever, stiff neck, rash, altered consciousness, seizures, double vision, muscle weakness, numbness, etc. are accompanied · Headache after a severe head injury · Headache after coughing, exercise, or sudden movement · Headache that begins after age 50

2. Treatment methods for migraine Treatment methods for migraine are broadly divided into medication treatment and non-drug treatment. Above all, avoiding headache triggers and maintaining the right lifestyle habits that can prevent headaches are most important.

Various medications are effective for migraine. Some medications not only treat migraine but also have preventive effects. Migraine treatment can be divided into acute treatment, in which pain relievers are used after a migraine starts or when one is about to begin, and preventive treatment, in which medication is taken regularly every day to reduce the frequency and intensity of migraines.

1. Pain relievers

(1) Non-specific medications · Aspirin     · Acetaminophen     · Butalbital combination preparations     · Other nonsteroidal anti-inflammatory drugs · Caffeine     · Narcotic analgesics (opioid analgesics)     · Antinausea medications

2. Migraine-specific pain relievers · Triptans     · Ergotamine medications

3. Preventive treatment People who take migraine medications should check how often they are taking them. If they are using medication on 9 or more days a month, preventive medication is needed. Preventive treatment is used not only to reduce the frequency, intensity, and duration of migraines, but also to increase the effectiveness of medications that relieve migraine symptoms. Situations in which preventive treatment should be considered include the following:

· When migraine attacks are frequent and daily life is significantly impaired by migraine despite acute migraine treatment   (when attacks more than twice a month cause disruption to daily life for 3 days or more) · When acute medications cannot be used or do not respond · When there is medication overuse · When migraines occur frequently in a week

Types of preventive medications (1) Cardiovascular medications     (2) Antidepressants    (3) Antiepileptic medications

3. Proper use of migraine medications You can check whether a migraine medication works well for you by answering the following questions.

· Does the headache go away within 2–4 hours? · Can you return to daily life within 3–4 hours? · Does it work in at least 50% of cases after taking the medication? · Is taking the prescribed medication comfortable and does it not interfere with daily life?

If you answered "No" to one or more of the above questions, you need to reconsider the migraine medication. By using the treatment medication during 2–3 migraine attacks and monitoring the situation, you can choose the appropriate medication. If a similar degree of effectiveness was seen in two similar headache situations, the chance of getting a similar effect a third time can be predicted to be about 70%.

To prevent treatment failure, it is important to take the medication at the proper time. If a headache has started, you should take the headache medicine as soon as possible. If taking the medication is delayed from the time the headache starts, the chance of failure increases. Usually, the first hour after the headache begins is called the "window of opportunity," and if treatment is started during this time, the chance of success is high.

So far, I have explained the treatment of migraine. In the next article, as the final part of the migraine series, we will look at migraine prevention.

Source: Korea Centers for Disease Control and Prevention, National Health Information Portal