Treating migraines

The effectiveness of migraine treatment depends on several factors, including whether a patient has identified likely triggers, how successful the patient is in avoiding identified triggers, how proactive the patient is in using treatments such as relaxation or drugs, and how well the patient responds to treatment.

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Medications may be prescribed both to relieve symptoms associated with migraines and to prevent migraines from happening.

Migraine medications are most effective when used in combination with other approaches, such as dietary and lifestyle changes, exercise, and relaxation therapy. They can be grouped into three different categories, described in this section:

• Symptomatic relief
• Abortive therapy
• Preventive medication

For those with menstrual migraines, a common approach is for the patient to take a nonsteroidal anti-inflammatory drug (NSAID) on a scheduled basis starting two to three days prior to the onset of the menses (or migraine, if predictable) and continue taking it throughout the menstrual flow. More detail can be found in the section on treating migraines in women.

Behavioral techniques can reduce the frequency of the migraines without use of medications. One common method is biofeedback, which involves training individuals to recognize stressful situations and to relax and control the amount of distress they experience. If the migraine begins slowly, many people can use biofeedback to stop the attack before it becomes full blown.

Physical therapy as well as a general aerobic exercise program can provide additional benefits.

Treatment options for cyclic migraines, a form of migraine that occurs in cycles, have included lithium and indomethacin, a nonsteroidal anti-inflammatory drug. Standard antimigraine therapy may be ineffective for cyclic migraine.

All of these treatments should be used under the direction of a headache specialist or physician familiar with migraine therapy. As with any medication, it is important to carefully follow the label instructions and your physician's advice.

This section also contains information on treating migraine headaches in children and in women.