The treatment of migraine and headache is divided into emergency and preventive treatment. The purpose of the emergency treatment is to quickly stop an ongoing headache attack, while the preventive treatment should reduce the number of attacks or prevent them from coming at all. By combining different emergency and preventative methods, treatment will have the most significant effect.
In the longer term, preventative treatment contributes to the reduction of headache attacks or to ceasing altogether. Usually, it is an addition to the emergency treatment for those who have more than two attacks per day or long periods of trouble. It is often successful in combining two different treatments, but everyone who has headaches and/or migraines is different, and the treatment must be tailored to each individual. Therefore, it is essential that the treatment is performed by a specialist in neurology who knows both the disease and the affected person.
Often the medical treatment from doctors is concentrated on emergency treatments, mainly in the form of different kinds of medicine. While preventive treatments are something that primarily depends on you. In the following blog post, I will go through and give you a lot of tips and tricks of things that can help you in so many ways possible. In this blog post, I will focus on the medication part of headache and migraine that is mostly offered.
When it comes to headaches and migraines, they are painful, and therefore, it is crucial with urgent treatment that quickly relieves or stops the attack. Medical oxygen and triptans are the two most effective and most studied emergency methods. If you have a severe form of Cluster headache (Hortons), with many attacks per day, it’s possible to combine medical oxygen with triptans to increase the effect of the treatment. To enhance these two is also an option when you have more than two headache attacks per day, and thus, the triptan consumption risks becoming too high.
I will also point out that medications and treatment can vary between different continents, countries, and regions. If you have any other experiences from where you live, please share your experiences with both other medications, treatments that are offered where you live, as well as remedies that have worked for you.
Medical oxygen increases blood oxygen levels and causes blood vessels to contract, which contributes to the complete or partial headache disappearing within 10 to 15 minutes. In a headache attack, you breathe in 7-15 liters of oxygen per minute through a face mask for up to 15 minutes. The treatment helps about 70% and relieves the attack directly for some while taking the headache out of the pain and making it more bearable for others. Medical oxygen is written on prescription and is then included in the high-cost protection and produces few side effects.
Triptans are a collective name for a group of drugs that contract blood vessels and reduce the release of vasodilators in the head. In a headache attack, 6 mg of triptan can be injected sumatriptan using a pre-filled syringe. The maximum dose is two doses per day, and at least one hour must pass between injections. 70-80% respond to the treatment and feel that the pain relieves or disappears within 5-10 minutes. The treatment has no serious documented side effects but can give a depressing feeling over the neck and chest, which is harmless but can be uncomfortable. Triptans should not be used when suffering from uncontrolled high blood pressure or angina.
Other emergency treatment methods
There are several other emergency treatment methods that can help headaches and migraines, but they only work after about 30-45 minutes. The sumatriptan and zolmitriptan are available as a nasal spray as well as the local anesthetic lidocaine. A nasal spray is a medical treatment that many people find helpful. Another alternative is ergotamine, which is available both as a tablet and suppository.
Calcium antagonists in tablet form, are used specifically with migraine or cluster headaches (Hortons) and can be taken up to three times a day during a headache period. Over 70% experience, a good preventative effect, and the drug can be combined with triptans or ergotamine. A common side effect is constipation.
Cortisone by drops or in tablet form acts as a short-term treatment for 2-3 weeks and helps in 60% of cases. It is used in migraine and severe Cluster headache (Hortons) with many attacks or while waiting for another preventative treatment to take effect.
Ergotamine pulls together the blood vessels in the brain and is taken in the evening to prevent attacks during the night. The risk of side effects is rather significant, and treatment should not last for more than a few weeks. Ergotamine interacts with triptans and should not be combined with sumatriptan or zolmitriptan.
Lithium sulfate in tablet form is an alternative to severe chronic Cluster headaches (Hortons). The treatment should be performed by a physician with long experience of Cluster headache, and regular blood tests must be taken to check that the kidneys or thyroid are not affected.
Pizotifen is a tablet serotonin antagonist that can relieve the problems of chronic Cluster headache (Hortons) and is given with ergotamine or triptans.
Operative methods in the form of DBS (deep brain stimulation) means that the hypothalamus is electrostimulated. The treatment is used in very severe cases of chronic Cluster headaches (Hortons) when medication does not help.
Behavioral therapy can be a useful complement to drug therapy. Biofeedback, relaxation exercises, cognitive behavioral therapy, and stress management are some examples of methods that help to manage the pain better and feel control over their condition.