Migraine

Prevention

There are a number of ways you can reduce your chances of experiencing migraines.

Identifying and Avoiding Triggers

One of the best ways of preventing migraines is recognising the things that trigger an attack and trying to avoid them.

You may find you tend to have a migraine after eating certain foods or when you're stressed and by avoiding this trigger, you can prevent a migraine. These medicines are usually used if you've tried avoiding possible triggers but you're still experiencing migraines.

You may also be prescribed these medicines if you experience very severe migraine attacks, or if your attacks happen frequently.

Main Medicatons

Some of the main medications used to prevent migraines are outlined below.

Topiramate

Topiramate is atype of medication originally developed to prevent seizures in people with Epilepsy , but is now much more commonly used in migraine. It's been shown to help prevent migraines and is usually taken every day in tablet form.

Topiramate should be used with caution in people with kidney or liver problems. It can also harm an unborn baby if taken during pregnancy and can reduce the effectiveness of hormonal contraceptives, so your GP should discuss alternative methods of contraception with women who are prescribed topiramate.

Side effects of topiramate can include:

Decreased appetite
Nausea
Vomiting,
Constipation or diarrhoea
Dizziness
Drowsiness
Problems sleeping

Propranolol

Propranololis a medication traditionally used to treat angina and high blood pressure , but it's also been shown to effectively prevent migraines. It's usually taken every day in tablet form.

Propranolol is unsuitable for people with asthma , chronic obstructive pulmonary disease (COPD) and some heart problems. It should be used with caution in people with diabetes .

Side effects of propranolol can include:

Cold hands and feet
Pins and needles
Problems sleeping
Tiredness

Botulinum Toxin Type A

In June 2012, NICE recommended the use of a medication called botulinum toxin type A by headache specialists to prevent headaches in some adults with chronic (long-term) migraine.

Botulinum toxin type A is a type of neurotoxin (nerve toxin) that paralyses muscles. It's not exactly clear why this treatmentcan be effective for migraine.

NICE recommends that this treatment can be considered as an option for people who have chronic migraine (headaches on at least 15 days of every month, at least eight days of which are migraine) that hasn't responded to at least three previous preventative medical treatments.

Under the NICE guidelines, botulinum toxin type A should be given by injection to between 31 and 39 sites around the head and back of the neck. A new course of treatment can be administered every 12 weeks.

Preventing Menstrual-Related Migraines

Menstrual-related migraines usually occur between two days before the start of your period to three days after. As these migraines are relatively predictable, it may be possible to prevent them using either non-hormonal or hormonal treatments.

Non-hormonal Treatments

The non-hormonal treatments that are recommended are:

Non-steroidal anti-inflammatory drugs (NSAIDs) a common type of painkiller
Triptans medicines that reverse the widening (dilation) of blood vessels, which is thought to be a contributory factor in migraines

These medications are taken as tablets two to four times a day from either the start of your period or two days before, until the last day of bleeding.

Hormonal Treatments

Hormonal treatments that may be recommended include:

Combined hormonal contraceptives, such as the combined contraceptive pill, patch or vaginal ring
Progesterone-only contraceptives , such as progesterone-only pills, implants or injections
Oestrogen patches or gels, which can be used from three days before the start of your period and continued for seven days

Hormonal contraceptives aren't usually used to prevent menstrual-related migraines in women who experience aura symptoms because this can increase your risk of having a stroke . Read about the complications of migraines for more information about this.

Acupuncture

If medication is unsuitable, or it doesn't help to prevent migraines, you may want to consider acupuncture.

NICE states that a course of up to 10 sessions over a five to eightweek period may be beneficial.

Medically Reviewed by a doctor on 29 Nov 2016

Articles for migraine

Introduction

A migraine is usually a severe headache felt as a throbbing pain at the front or side of the head. Many people also have symptoms such as nausea, vomiting and increased sensitivity to light or sound. Migraine is a common health condition, affecting around one in every five women and around one in every 15 men. They usually begin in early adulthood.

Symptoms

The main symptom of a migraine is usually an intense headache that occurs at the front or on one side of the head. Other symptoms commonly associated with a migraine include: nausea, vomiting, increased sensitivity to light and sound which is why many people with a migraine want to rest in a quiet, dark room. Some people also occasionally experience other symptoms, including: sweating, poor concentration, feeling very hot or very cold, abdominal (tummy) pain, diarrhoea.

Causes

The exact cause of migraines is unknown, but they're thought to be the result of abnormal brain activity temporarily affecting nerve signals, chemicals and blood vessels in the brain. It's not clear what causes this change in brain activity, but it's possible that your genes make you more likely to experience migraines as a result of a specific trigger.

Diagnosis

There's no specific test to diagnose migraines. For an accurate diagnosis to be made, your GP must identify a pattern of recurring headaches along with the associated symptoms. Migraines can be unpredictable, sometimes occurring without the other symptoms. Obtaining an accurate diagnosis can sometimes take time.

Treatment

There is currently no cure for migraines, although a number of treatments are available to help ease the symptoms. It may take time to work out the best treatment for you. You may need to try different types or combinations of medicines before you find the most effective ones. If you find you can't manage your migraines using over-the-counter medicines, your GP may prescribe something stronger.

Complications of migraine

Migraines are associated with a small increased risk of ischaemic strokes, and a very small increased risk of mental health problems. Studies have shown that people who experience migraines (particularly migraine with aura) have about twice the risk of having an ischaemic stroke at some point compared to people without migraines.

Prevention

There are a number of ways you can reduce your chances of experiencing migraines. One of the best ways of preventing migraines is recognizing the things that trigger an attack and trying to avoid them. You may find you tend to have a migraine after eating certain foods or when you're stressed and by avoiding this trigger, you can prevent a migraine.