About Migraines
Migraine headaches are characterized by throbbing or pulsating pain, starting on one side of the head at the front of the skull, and gradually progressing to encompass the whole head. Symptoms can include sensitivity to light and sound, nausea, changes in vision and numbness in the hands, arms and face.
The cause of migraine headaches is not understood, but the physiology of the headache itself is. Vascular nerve activity induces the release of substances that dilate the blood-vessel wall and cause inflammation, leading to pain. All of the drugs used for migraines work on either the substances released by this activity or the symptoms they cause.
NSAIDs
Non-steroidal anti inflammatory drugs are available over the counter. Medications like acetaminophen, asprin, ibuprofen and naproxen are all NSAIDs. These drugs work to reduce inflammation, thereby reducing pain. Some NSAIDs specifically for migraines contain caffeine, which acts as a vasoconstrictor. About 1/3 of migraine patients have success with these drugs.
Prescription: Acute
Midrin is a combination of vasoconstrictor, anti-inflammatory and sedative drugs. The sedative aids in pain relief by depressing the central nervous system.
Increasing brain chemicals called neurotransmitters can mitigate the effects of the substances produced by vascular nerve activity. Sumatriptan, Amerge and Zomig are drugs that work on the neurotransmitter serotonin. Topamax is an anticonvulsant that enhances transmission of the neurotransmitter GABA. Cafergot is a vasoconstrictor that also works on serotonin and dopamine.
Prescription: Preventive
These drugs are given to prevent migraines from occurring, rather than to decrease pain during a migraine
Inderal is a beta blocker that keeps blood vessels from expanding, increases the release of oxygen to the tissues and stabilizes cell membranes. Depakote is an anticonvulsant that enhances GABA transmission.
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