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Medicineworld.org: A primer on migraine headaches

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A primer on migraine headaches




Migraine headache affects a number of people and many different preventative strategies should be considered, states an article in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj081657.pdf. The article, a primer for physicians, outlines various therapys and approaches for migraine headaches.

Migraine headache is a common, disabling condition. When migraine headaches become frequent, treatment can be challenging. Preventative treatment for migraines remains one of the more difficult aspects, as while there are valid randomized controlled trials to aid decision making, no drug is completely effective, and most have side effects.



A primer on migraine headaches

Medications used for migraine can be divided into two broad categories: symptomatic or acute medications to treat individual migraine attacks, or preventative medications which are used to reduce headache frequency. Symptomatic migraine treatment alone, eventhough helpful for a number of patients, is not adequate therapy for all. Patients with frequent migraine attacks may still have pain despite treating symptoms, and when symptomatic medications are used too often, they can increase headache frequency and may lead to medicine overuse headache.

Physicians need to educate patients about migraine triggers and lifestyle factors. Common headache triggers include caffeine withdrawal, alcohol, sunlight, menstruation and changes in barometric pressure. Lifestyle factors such as stress, erratic sleep and work schedules, skipping meals, and obesity are linked to increased migraine attacks.

Overuse of symptomatic headache medications is considered by headache specialists to make migraine treatment less effective, and stopping medicine overuse is recommended to improve the chance of success when initiating doctor prescribed treatment.

When preventative treatment is initiated, 1 of 3 outcomes can be anticipated. Patients may show improvement, with 50% or more a reduction in headache frequency which can be assessed using a headache diary. People may develop side effects such as nausea or weight gain, or the drug appears to be ineffective in some individuals.

An adequate trial of medicine takes 8 to 12 weeks, and more than one medicine may need to be tried. There is little evidence about how long successful migraine therapy should be continued but recent studies suggest that most patients relapse to some extent after stopping medication.


Posted by: Daniel    Source




Did you know?
Migraine headache affects a number of people and many different preventative strategies should be considered, states an article in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj081657.pdf. The article, a primer for physicians, outlines various therapys and approaches for migraine headaches.

Medicineworld.org: A primer on migraine headaches

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