Migraine is a complex neurological condition. It often leads to a throbbing or pulsing headache on one side, with or without nausea and vomiting, an aversion to light, or seeing flashes or spots of light.
It is an episodic condition but these symptoms can last for hours or days. Many people who experience migraine have a lead-up period before the migraine attack when their mood changes and they have gastrointestinal symptoms, such as constipation. Migraine is caused by over-activity in the brain.
It is a common condition in Australia. Studies have shown between one in 10 and one in five people experience migraine. ¹ Some research suggests many more people experience migraine but are not aware their symptoms are those of migraine ². The condition affects three times as many adult women than men. ³
Medications can help prevent and reduce the severity of migraines in most people. For others, lifestyle changes can assist the treatment of migraine. ⁴ ⁵
Whether it’s paper or digital prescriptions, Chemist2U always keeps managing your repeats in mind.
- With paper prescriptions your repeat prescription will be printed at the pharmacy and sent back with your medication. This will be attached with the customer copy of the original script to enable you to reorder. Alternatively, your repeat prescription can be held by the pharmacy, making it even easier if you plan to order your repeat using Chemist2U.
- With electronic prescriptions, repeats are automatically issued back to you via SMS or email.
- Chemist2U also provides a reminder service for those with repeat prescriptions. When you order prescription medicine online with Chemist2U, we securely store this information and email you a reminder when you are required to restock your prescription.
Here are five tips to manage your migraines
1. Observe your symptoms
People who experience migraine can be sensitive triggers such as hormones, foods, stress, or changes in sleep or routines, among other things. It helps you and your health professionals if you keep a detailed diary including your sleep, diet, hormones, medications, stress levels and other potential triggers. This can help to identify patterns.
2. Check with your general practitioner or a neurology specialist for a diagnosis
Migraine is underdiagnosed and often misdiagnosed.5 The right diagnosis is important so people can access the correct treatments for their condition, including preventative medications. Your migraine might get worse over time, so it is important to start effective management as soon as possible.
According to the International Headache Society, a migraine diagnosis involves:
- Migraine attacks that come and go
- Attacks of between four hours and 72 hours
- Headache that is moderate to severe, on one side only, throbbing, and made worse by movement
- Accompanying nausea or vomiting, or light sensitivity, or noise sensitivity.
3. Treat the migraine attack quickly
Early treatment during a migraine attack is important. With the awareness of symptoms leading up to a migraine attack, many people can prevent or reduce it successfully. This could be by sitting or lying in a darkened room with a cold compress on the forehead.
Once an attack is underway, however, combination treatments of anti-vomiting medications, painkillers such as paracetamol, aspirin may be recommended.⁶
These medications help to reduce symptoms and may prevent the attack getting worse. Other medications can include NSAIDs, which are nonsteroidal anti-inflammatory drugs.
If a moderate to severe migraine attack is underway, however, triptan or dihydroergotamine (DHE) medications are recommended. Triptans are used more commonly as they are available in a wider range of dosages and are generally better tolerated with fewer side effects. They narrow the blood vessels in the brain, reducing the symptoms. However, people who have heart conditions should not use triptans. Likewise, they can have side effects including feeling flushed or tingly, or heaviness in the face, limbs or chest.
For severe attacks, it is recommended to see a health professional, who may use nasal or injectable medications.
Preventative migraine treatments
Preventative treatments are also available. A doctor may recommend these medications if you have more than three attacks a month that do not respond to treatment, or more than six to eight headache days a month. A doctor may prescribe these if you’re at risk of developing medication-overuse headaches.
Medications used for migraine prevention depend on the personal and health circumstances of the person living with migraine. A range of medications such as hypertension drugs, and those for depression and epilepsy have also been found to improve migraine due to their neurochemical effects.
A new drug class called calcitonin gene-related peptide antibodies (CGRP) monoclonal antibodies – commonly known as CGRP medications – may be available for people who experience chronic migraine, which may result in fewer and milder attacks.⁷
These emerging medications are the first new treatments for migraine in a generation.
4. Lifestyle and supportive therapies for migraine
Some people experience a reduction in their migraine symptoms from lifestyle changes and other allied health supports. Avoiding triggers mentioned above also improves the symptoms of migraine.
For some people, maintaining a regular and healthy diet may help. For others, sticking to a regular routine and reducing stressors reduces the frequency of attacks.
Exercise has been demonstrated to be safe and benefit many people with migraine, in small studies.
Research has also shown that acupuncture can assist to reduce migraine attack pain, and the frequency of episodes in small trials.
5. Take special care if you are pregnant or breastfeeding
Women who are pregnant or breastfeeding should take additional care to manage their migraine.⁸ While migraine impacts actually reduce during pregnancy for more than half the women who commonly experience the condition, the changed hormones of pregnancy may increase other headaches.
Non-medication treatments such as ice packs, relaxation and sleep should be tried first. Seek additional medical assistance from a doctor during pregnancy. Triptans are not recommended for women who are pregnant.
This is general information only.
We recommend you see a healthcare professional to seek specific advice. Always check with your medical professional if your symptoms continue. All medications and supplements can have side effects. Consult your pharmacist or doctor before starting a new medication, or if your health circumstances have changed.
Resources:
1. Wijeratne T. et al., “Prevalence of Migraine in the Elderly: A Narrated Review”, Neuroepidemiology, 2019;52:104–110, https://doi.org/10.1159/000494758, accessed February 2022.
2. Yeh, W., et al., “What is the actual prevalence of migraine?, “ Brain and Behavior, 2018 Jun 8(6), https://doi: 10.1002/brb3.950, accessed February 2022.
3. Migraine Australia, Burden of Migraine, https://www.migraine.org.au/burden, accessed February 2022.
4. https://www.ajmc.com/view/migraine-overview-and-summary–of-current-and-emerging-treatment-options
5. Burch, r., Migraine and Tension-Type Headache: Diagnosis and Treatment, Medical Clinics of North America, 2019 Mar; 103(2):215-233. doi: 10.1016/j.mcna.2018.10.003., accessed February 2022.
6. Peters, G., “Migraine Overview and Summary of Current and Emerging Treatment Options, Emerging Therapies for the Prevention and Management of Migraine, 2019, 25: 2, https://www.ajmc.com/view/migraine-overview-and-summary–of-current-and-emerging-treatment-options, accessed February 2022.
7. Ibid.
8. Wells RE, et. al,. Managing Migraine During Pregnancy and Lactation. Curr Neurol Neurosci Rep. 2016 Apr;16(4):40. doi: 10.1007/s11910-016-0634-9. PMID: 27002079., https://link.springer.com/article/10.1007%2Fs11910-016-0634-9, accessed February 2022.
