What is a Migraine?
A migraine can be defined as a severe headache, with a throbbing pain on one side of the head. It is a common medical condition that has a variety of measures to treat migraine attacks.
A migraine is a neurological condition that affects the nervous system and is thought to be the result of abnormal brain activity that temporarily affects the nerve signals, chemicals and blood vessels in the body. It involves a complex network of neurons and anatomical regions of the brain. The exact mechanism of how a migraine occurs is not understood but there are multiple theories.
There are different types of migraine which are categorised by the symptoms experienced.
The condition has a global prevalence of approximately 1 in 7 people. Migraines are two to three times more common in women with a lifetime prevalence of 33% in women and 13% in men after puberty.
They occur at any age but are most common from the age of 25 to 55.
A migraine with aura is a headache which is accompanied by warning signs. These warning signs can include visual disturbance. Other symptoms include flashing lights, seeing zigzag lines, numbness or tingling in parts of the body etc.
A migraine without aura is a migraine which has no warning signs.
A silent migraine is a migraine aura without a headache. This is when you experience the aura symptoms such as a tingling sensation or flashing lights, or double vision, but the headache is absent.
What Causes Migraines?
Migraines can be caused by internal and external factors.
Genetics could be the cause of your migraine. Over 80% of patients who suffer from migraines have a close family member who is also suffering from the same medical condition.
Migraine headaches can also be caused by environmental triggers. These are external factors, some of which can be controlled, such as certain foods. These foods can trigger migraine symptoms and it is advised to keep a migraine diary to document meals in order to help identify the cause.
Environmental triggers include:
Certain foods - aged cheese, alcohol, chocolate, caffeine etc.
Hormonal changes e.g. starting your period - This is why women may experience migraines more than men. Oestrogen affects the narrowing of blood vessels, so when a woman's body experiences hormonal fluctuations, the oestrogen levels rise and fall, contributing to migraines.
Not eating regularly or skipping meals
Anxiety and/or depression
Not getting enough exercise
What are the Symptoms of a Migraine?
There is more than one type of migraine. The three main types are Migraine with aura, Migraine without aura and Migraine aura without headache (silent migraine). Both of these types present with different symptoms and are sometimes accompanied by warning symptoms which are signs that you are about to have a migraine.
There are four stages that a migraine typically goes through. Not every individual experiences every stage and some may overlap.
Stage 1 - Prodrome
This stage typically lasts from a few hours to a few days. Prodrome is the period before a migraine begins. Symptoms you may experience during this stage are irritability, yawning, food cravings, fatigue etc.
Stage 2 - Aura
Aura is the second stage and typically lasts between 5 and 60 minutes. Here, you may experience visual disturbances, temporary loss of sight and numbness and tingling in parts of the body.
Stage 3 - Headache
This stage is where the attack occurs and can last between 4 and 72 hours. It may consist of throbbing pain on one side of the head with nausea, vomiting, neck pain and stiffness, insomnia, increased sensitivity to light, sound and smell, etc.
Stage 4 - Postdrome
Postdrome is the final stage of a migraine and can last between 24 and 42 hours. It is at this stage you may feel you have a depressed mood, fatigue, inability to concentrate or a euphoric mood.
How are Migraines Diagnosed?
If you believe you are suffering from migraines, it is important to see your doctor for a confirmed diagnosis.
There are no specific tests available that can be used to diagnose migraines. Diagnosis confirmation must be made by analysing the pattern of the headaches alongside the associated symptoms.
A migraine diary can also be used to note down the following details to help with diagnosis:
How long the attack lasted
What you were doing when the migraine started
Symptoms you experienced
Medications you took to relieve the symptoms (if any)
When being diagnosed by a GP, they may do a physical examination, and check your vision, coordination, reflexes and sensations.
What are the Available Migraine Treatments?
Treating migraines is easy with us at Quick Meds. We have a range of products available to treat a migraine headache and its associated symptoms.
The following medicines are products we have available for the relief of migraine symptoms.
Sumatriptan tablets temporarily widen the blood vessels which reduces the symptoms of a migraine. A single dose is taken when an attack begins.
This injection is to be used once an attack begins. It must not be used to prevent an attack.
Sumatriptan Nasal Spray (Imigran Nasal Spray)
Sumatriptan nasal spray is to be used in one nostril once a headache begins. Each nasal spray contains one dose of sumatriptan.
These tablets work in the same way as sumatriptan. They are to be taken once an attack begins and can also be used for a second attack, provided it is 2 hours after the first.
These tablets are placed on the tongue and dissolve in the mouth. They cannot be used to prevent future attacks.
These work to treat migraines in the same way as the above-mentioned tablets.
Zolmitriptan Nasal Spray (Zomig Nasal Spray)
Zomig nasal spray is a ready-to-use spray unit.
How Do Migraine Tablets Work?
Sumatriptan, rizatriptan and zolmitriptan are all part of a group of medications called 'triptans'. They work by narrowing the blood vessels by essentially reversing the widening of the blood vessels that is caused by changes in the brain. They are not intended for preventing migraines and must only be used when a migraine has started.
The triptans are available as tablets, tablets that dissolve on the tongue, nasal sprays and injections. They are all acute treatments meaning they are taken and work once a migraine headache has begun. They can be taken alongside over-the-counter painkillers such as paracetamol and ibuprofen which are used to relieve associated pain.
Please do not take triptans if any of the following apply:
you’re under 18 years old or over 65 years old
you’re pregnant or breastfeeding
you’re a heavy smoker (20 cigarettes or more per day) or are taking stop smoking medicine
you have severe liver or kidney conditions
you suffer from epilepsy
you suffer from heart disease
you are not suffering from a migraine
you have uncontrolled high blood pressure
Preventative treatments are available. You will need to see your GP or appropriate healthcare professional to discuss preventative treatment for a migraine.
Painkillers in Migraine Treatment
Over-the-counter painkillers can be used in migraine treatment and are readily available to purchase from your local pharmacy. They can help to relieve migraine attacks.
Paracetamol, Ibuprofen and Aspirin are commonly used to treat the pain. They are most effective if they are taken once the first signs of attack become apparent. Do not wait to take painkillers until the headache worsens.
A soluble painkiller may be a better option as it is absorbed into the bloodstream quicker than a standard tablet.
Suppositories are available for individuals who have difficulty swallowing tablets or have trouble swallowing due to nausea and/or vomiting.
Triptans in Migraine Treatment
As mentioned above, triptans are used in the treatment of migraine. There are multiple triptans, each with more than 1 type of formulation.
Sumatriptan - Sumatriptan is available in the form of a tablet, nasal spray and injection.
A Sumatriptan tablet is taken at the onset of symptoms. The dose may be repeated if a second migraine occurs. It can only be taken the second time if a new migraine develops or the symptoms return after two hours. A second tablet cannot be taken for the same initial attack.
The nasal spray is administered into one nostril when an attack begins. It can only be used twice a day for two different migraines.
Sumatriptan injection is administered into the thigh or upper arm once an attack occurs. It can be followed by another dose 1 hour after the initial if the migraine reoccurs.
Zolmitriptan tablets and nasal sprays work in the same way as sumatriptan products.
Rizatriptan tablets are available in classical tablet form and in a version that melts when placed on the tongue. This is advantageous for those who have difficulty swallowing or are feeling nauseous and sick and cannot swallow a tablet.
All of the products mentioned above have beneficial effects if used as soon as a headache begins.
Anti-sickness Treatments for Migraines
Some patients may experience sickness when they have a migraine. Anti-sickness medicines are available via our migraine clinic to help alleviate this symptom.
An anti-sickness medicine works by blocking dopamine. Dopamine is a molecule in the body that carries messages between nerve cells and can trigger nausea and vomiting. This molecule is blocked by the anti-sickness medication and so relieves an upset stomach.
Nausea and vomiting can make an individual feel a lot worse, especially if they are already suffering from a throbbing headache. Anti-sickness tablets are an important factor in treatment and it is a good idea to keep a box handy if you anticipate feeling sick.
The anti-sickness treatment we have available at Quick Meds is the Prochlorperazine buccal tablet. It is a once or twice-daily tablet that is placed in the buccal cavity, high up along the top gum under the upper lip, until dissolved.
What are the Alternative Treatments for Migraine?
Migraines can be managed medicinally or naturally.
Below are some tips to help manage migraines naturally.
Regular exercise- Exercise is an activity that releases endorphins and endorphins can be considered the body's natural painkiller.
Avoid trigger foods- trigger foods include chocolate, aged cheese, alcohol, processed foods, and foods containing nitrates e.g. hot dogs, deli meats etc.
Acupuncture- This practice has been proven to be effective at preventing migraine in those with episodic migraine without aura. It has also been shown to reduce headache symptoms.
Yoga- breathing, meditation and body postures improve and promote health and well-being. A study revealed that yoga may relieve the frequency, duration and intensity of migraine attacks.
Stress management techniques- A large proportion of individuals who report migraines suffer from stress-related migraines. Learning how to manage stress, may reduce the frequency of migraine. Some common techniques that are used to manage stress include deep breathing exercises, meditation, music therapy, counselling or therapy, practising self-care and many more.
Hydration- Staying hydrated is very important for general health but can also prevent a migraine from occurring. Drink plenty of water throughout the day, especially when exercising and/or on a hot day.
Sleep- There is a connection between sleep and migraine. It is not clear how they are related but a correlation has been found between high migraine frequency and poor quality sleep.
Eating- It is important to maintain a regular schedule for food. Avoid skipping meals or eating too late at night.
Biofeedback- Biofeedback is a relaxation method. It is a type of therapy where electrodes are applied to the skin to monitor physiologic processes that change with stress such as heart rate, blood pressure and muscle tension.
How You Can Manage Life with Migraines
Life with migraines can be difficult and troublesome but they can be managed.
Keeping a headache diary can help you figure out what is triggering your attacks.
Making your family, friends and employers aware of your condition may make it easier to reach out for assistance when an attack is making your daily routine or work life difficult.
If you experience regular migraines, it may be a good idea to implement certain activities into your life to trial whether they affect the frequency, this can include yoga or just general exercise, meditation, therapy and acupuncture.
Migraines can interfere with many aspects of an individual's life. It can limit a person's potential to continue with their daily life.
We have plenty of treatment options available at Quick Meds. If you suspect you have migraines or have already been diagnosed with them, our professional and confidential service is perfect for you.
Rizatriptan Maxalt Melt are migraine wafer melts. They are intended for the use of treating the headache phase in a migraine. They work by reducing the swelling of the blood vessels surrounding the brain. Maxalt Melt does not need to be taken with water because it melts in the mouth when placed on the tongue.
Migraine tablets, also known as triptans, can be very effective in treating migraines, especially when taken as soon as an attack begins.
Migraines are genetic. A family history of migraines could increase your likelihood of the neurological disorder.
- Not eating regularly
- Certain foods - aged cheese, chocolate, processed meats, MSG, cold foods and drinks, caffeine etc.
- Lack of sleep
- Excessive and loud noises
- Certain smells
- Hormone fluctuations