Migraine Treatment

Migraines are a common condition which usually, but not always, feel like a bad throbbing headache. They can particularly hurt down one side of your head, and you may have other symptoms as well as a headache. These can include feeling or being sick, and being very sensitive to light or sound. There are three different types of migraine:

• migraine without aura – the most common type
• migraine with aura
• silent migraine (migraine aura without headache)

An aura is when you have a sensory disturbance just before or during the headache. The disturbances are often flashing lights or blind spots.

If you have a migraine without aura, you don’t have any warning signs before the headache develops.

The most common migraine symptom is a severe headache lasting up to several days. Additional symptoms include:

• feeling sick
• being sick
• unusual sensitivity to light or sound

Some people also experience the following when they have a migraine:

• tummy pain
• diarrhoea
• dizziness
• sweating
• poor concentration
• feeling very cold or very hot

Aura warning signs of a migraine

An aura is when you experience temporary warning symptoms before or as you get the migraine headache. These symptoms can include:

• seeing flashing lights, blind spots, or patterns in your vision
• a tingling or numbness, which usually starts in one hand and moves up your arm to your face, lips, and tongue
• difficulty speaking
• feeling dizzy
• problems with your hearing

Studies estimate that 1 in 3 people get these warning signs. They usually develop over five minutes and can last for an hour.

Other warning signs of a migraine

Some people experience the following symptoms just before they get a migraine:

• a stiff neck
• peeing more frequently
• feeling very tired
• yawning a lot
• sudden mood changes
• being very thirsty or craving certain foods

What is the difference between a migraine and a headache?

The difference between a migraine and a headache is that a migraine is a much more severe pain. Compared to headaches, migraines are:

• intense
• debilitating
• longer lasting

Doctors don’t know the exact cause of migraines, but abnormal brain activity may temporarily affect the blood vessels in the brain, causing migraine.

It is common to get migraines if someone in your family gets them. Around half of all people who get migraines have a close family member who also gets them.

It is also common that something triggers your migraine. Some people have no triggers, but others find it helpful to keep a diary to understand if something in their life is making it more likely they will get a migraine. Triggers can be:

• physical – tiredness, poor sleep, bad posture, low blood sugar or fasting, or tension
• emotional – stress, anxiety, excitement, depression, or shock
• hormonal – related directly to the menstrual cycle (known as menstrual-related migraine)
• medication-related – some sleeping pills, the combined contraceptive pill, or hormone replacement therapy
• dietary – alcohol, caffeine, some specific foods, the additive tyramine, being dehydrated, or irregular eating
• environmental – bright lights, flickering screens, loud noises, smoking, strong smells, or changes in the weather

You can treat migraines in many different ways, including painkillers that you get over-the-counter, such as paracetamol and ibuprofen, prescription medication from your doctor, and lifestyle changes. You can also take medication (called anti-emetics) to help with the nausea and sickness that often come with a migraine.

Here at Superdrug Online Doctor, we can help you order prescription migraine treatment online. After completing a short online form about your symptoms, one of our doctors will review your answers and can issue you with a prescription if appropriate, which is then delivered quickly to an address of your choice.

Over-the-counter painkillers

Over-the-counter painkillers include paracetamol, aspirin, and ibuprofen. Take some of these as soon as you have signs of getting a migraine so there is time for your body to absorb them. If you wait until the headache worsens, it can be too late for the medication to work effectively.

Tablets that dissolve in water can stop the pain more quickly as the medication is absorbed more rapidly into the body. These are a good choice for anyone who suffers from nausea or vomiting.

Be careful if you take painkillers regularly to ease the pain of a migraine, as this can lead to a medication overuse headache. Doctors recommend not taking painkillers for headaches more than 15 days per month. Talk to your doctor if you are worried about your use of painkillers.

Triptans

Triptans are prescription medications used to treat migraines. They come as tablets, an injection, or a nasal spray. You may also hear them called 5-HT1 agonists. Triptans work by stimulating serotonin production to constrict blood vessels and stop the headache within 30 minutes to an hour of taking them.

Here at Superdrug Online Doctor, we have the following triptans available:

• Sumatriptan – tablets taken once to relieve migraine
• Imigran Nasal Spray – nasal spray used once to relieve migraine
• Migraitan Tablets
• Maxalt Melt Tablets
• Buccastem M
• Imigran Recovery

Take triptans only once you have the symptoms of a migraine, not just when you get signs of an oncoming migraine, like aura. If you take them too early, they can be less effective.

You can take triptans alongside over-the-counter painkillers and anti-sickness medications. Like other painkillers, getting medication overuse headaches from taking triptans is possible. Talk to your doctor if you take them more than 10 days a month. You may need to consider alternatives.

Gepants

Gepants are another type of medication that doctors can prescribe to treat migraines. They work differently from triptans because they do not tighten the blood vessels, making them a suitable treatment for people with heart-related conditions.

Gepants are a new treatment for migraine so there is less research into them than there is for triptans, but clinical studies so far show that they cause fewer side effects. These studies indicate that gepants work to stop migraine headaches within two hours of taking them.

At Superdrug Online Doctor, we can provide Vydura. Vydura is the brand name for rimegepant, which is a gepant.

Preventative medication

Doctors can prescribe medication to help prevent migraines. They usually only consider this if you are getting frequent migraines (more than 1 per week) despite avoiding possible triggers.

There are different options available, including beta blockers and calcium channel blockers. It can take a few weeks to determine the correct dose and whether the medication is suitable. We currently do not offer preventative migraine treatment at Superdrug Online Doctor.

What is the best treatment for migraine?

The best migraine treatment is often the one you are able to take as soon as you start to get symptoms. If you have to delay treating migraine, the symptoms can worsen. So, keeping your migraine treatment handy so you can take it as soon as you notice symptoms is important.

As with any medication, different people react in different ways to it. Figuring out which migraine treatment works best for you can take time, and you may need to try other options. You may also find that a treatment that works for you at one point does not work at another.

Talk to your doctor to ensure you understand all your options and what is best for your situation, considering any health conditions, your lifestyle, and other medications you’re taking.

The potential side effects of prescription migraine treatment vary depending on your medication. Some can be similar to the symptoms of a migraine. Do not operate machinery or drive if you experience the side effect of tiredness.

Triptans

If you take triptans, the following side effects are common:

• feeling or being sick
• tiredness
• dizziness
• feeling hot and cold

If you use the nasal spray, you may experience:

• burning or irritated throat
• nosebleed
• bad taste in the mouth

Most people find that the side effects are mild and do not last long, but always talk to your doctor or pharmacist if you are concerned or if the side effects are impacting your life.

Gepants

Information for gepants is more limited as it is a new medication, meaning fewer people have reported side effects.

The most common side effects reported in the clinical studies were:

• feeling sick
• tiredness
• dry mouth
• dizziness

Prescription medication to treat migraine may not be suitable for everyone to take.

It is important to tell your doctor if any of the following applies to you:

• severe liver problems
• reduced kidney function or dialysis
• you’re under 18
• you’re pregnant, breastfeeding, or planning to get pregnant

Also, tell the doctor prescribing you migraine treatment if you are taking any of the following medications, as they may affect the effectiveness of your migraine treatment:

• other migraine treatments
• antidepressants such as SSRI (selective serotonin reuptake inhibitors) or SNRI (serotonin noradrenaline reuptake inhibitors), or MAOI (monoamine oxidase inhibitor)
• itraconazole and clarithromycin to treat fungal or bacterial infections
• ritonavir and efavirenz to treat HIV infections
• St. John’s wort to treat depression
• bosentan to treat high blood pressure
• phenobarbital to treat epilepsy
• rifampicin to treat tuberculosis
• modafinil to treat narcolepsy

Understanding what triggers your migraines can help you prevent them. Keeping a diary of what you have been eating and doing before you get a migraine is an excellent first step to knowing if something triggers your migraine.

Doctors also recommend maintaining a healthy lifestyle as a way to avoid migraines, such as:

• getting enough sleep
• taking regular exercise
• staying hydrated
• eating healthily and at regular times
• maintaining a healthy weight
• limiting how much caffeine and alcohol you drink

It is possible to take medication to prevent you from getting migraines. Talk to your doctor about this option if you get more than one migraine a week and already avoid any triggers you know about.

There are many natural remedies for treating migraine, most of which are supposed to work by preventing you from getting a migraine, rather than treating it. However, there is limited medical evidence that they are effective.

There is some evidence that the following supplements may help prevent migraine, when taken regularly:

• magnesium – particularly thought to be useful for menstrual migraine and migraine with aura
• riboflavin (vitamin B2)
• coenzyme Q10 (CoQ10)
• feverfew
• butterbur

Always talk to your doctor before taking natural supplements, especially if you are pregnant or breastfeeding.

You cannot cure migraines completely. You can manage the symptoms through treatment, understanding what may trigger your migraines, and making lifestyle changes. This can reduce the number and severity of your migraines, and in some cases prevent them coming back, as long as you keep up the changes to your lifestyle.

Maintaining a healthy lifestyle to help you manage migraines can include:

• eating a healthy diet
• taking regular exercise
• staying hydrated
• getting plenty of sleep
• minimising your caffeine and alcohol intake