What causes migraines, and how do you cure them?

Question

i hate getting them! they just stop me from doing things

Answer 1

Migraine is a neurological disease, of which the most common symptom is an intense and disabling episodic headache. Migraine headaches are usually characterized by severe pain on one or both sides of the head and are often accompanied by photophobia (hypersensitivity to light), phonophobia (hypersensitivity to sound) and nausea. The word migraine is French in origin and comes from the Greek hemicrania (as does the Old English term megrim). Literally, hemicrania means "only half the head."

Migraine is irregularly episodic, so there needs to be some explanation for why a particular migraine episode occurs at a particular time and not at another time. A migraine trigger is any factor that on exposure or withdrawal leads to the development of an acute migraine headache. Triggers may be categorized as behavioral, environmental, infectious, dietary, chemical, or hormonal. The trigger theory supposes that exposure to various environmental factors precipitates, or triggers, individual migraine episodes. Many people report that one or more dietary, physical, hormonal, emotional, or environmental factors precipitate their migraines. The most-often reported triggers include stress, over-illumination or glare, alcohol, foods, too much or too little sleep, and weather. Sometimes the migraine occurs with no apparent “cause.”

Migraine patients have long been advised to try to identify personal headache triggers by looking for associations between their headaches and various suspected trigger factors. Patients are urged to keep a “headache diary” in which to note what they eat and when they get a headache, to look for correlations, and to try to avoid headache by avoiding factors they identify as triggers. Typically this advice is accompanied by a list of trigger factors.
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Food

Authors who in 2005 reviewed the medical literature[2] found that the available information about dietary trigger factors relies mostly on the subjective assessments of patients. Some suspected dietary trigger factors appear to genuinely promote or precipitate migraine episodes, but many other suspected dietary triggers have never been demonstrated to trigger migraines. The review authors found that alcohol, caffeine withdrawal, and missing meals are the most important dietary migraine precipitants. The authors say dehydration deserves more attention, and that some patients are sensitive to red wine. The authors found little or no demonstrated evidence that notorious suspected triggers chocolate, cheese, or that histamine, tyramine, nitrates, or nitrites normally present in foods trigger headaches. The artificial sweetener aspartame (NutraSweet®) has not been shown to trigger headache, but in a large and definitive study monosodium glutamate (MSG) in large doses (2.5 grams) was associated with adverse symptoms including headache more often than was placebo. The review authors also note that general dietary restriction has not been demonstrated to be an effective migraine therapy.

On the other hand, several headache clinics have had good results with individually tailored dietary restriction as a therapy. Dr. Ian Livingstone, director of the Princeton Headache Clinic, recommends eliminating the following common headache triggers from the diet: Aged Cheese, Monosodium Glutamate, Processed fish and meats containing nitrates (such as hot dogs), dark chocolate, aspartame, certain alcoholic beverages (including red wine), citrus fruits, and caffeine. After a period of a month or two, these foods can be reintroduced one at a time to determine their trigger potential for that individual. Adding a lot of the suspected trigger in a short time will generate a response that is easy to observe.

Dr. David Buchholz, who treats headaches as a neurologist at Johns Hopkins, has a longer list of suspected migraine triggers. Once again, he recommends eliminating the triggers from the diet altogether, and then reintroducing them slowly after many weeks to measure the effects. His list includes: Caffeine (including decaf), chocolate, monosodium glutamate, processed meats and fish (aged, canned, preserved, processed with nitrates, and some meats which contain tyramine), cheese and dairy products (the more aged, the worse), nuts, citrus and some other fruits, certain vegetables (especially onions), fresh risen yeast baked goods, dietary sources of tyramine (including the foods listed above), and whatever gives you a headache.
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Weather

Several studies have found some migraines are triggered by changes in weather. One study[3] noted that 62% of the subjects in the study thought that weather was a factor, in fact 51% were actually sensitive to weather changes. While those whose migraines did occur during a change in weather, often the subjects picked a weather change other than the actual weather data recorded. Most likely to trigger a migraine were, in order:

1. Temperature mixed with humidity. High humidity plus high or low temperature was the biggest cause.
2. Significant changes in weather
3. Changes in barometric pressure

Another study[4] studied whether chinook winds (warm westerly winds occurring in Alberta, Canada) are a migraine trigger. Many patients had increased incidence of migraines immediately before and/or during the chinook winds. The number of people reporting migrainous episodes during the chinook winds was higher on high-wind chinook days.

Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and preventive drugs. Patients who experience migraines often find that the recommended treatments are not 100% effective at preventing migraines.
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Trigger avoidance

Patients can attempt to identify and avoid factors that promote or precipitate migraine episodes. Moderation in alcohol and caffeine intake, consistency in sleep habits, and regular meals may be helpful. Beyond an often pronounced placebo effect, general dietary restriction has not been demonstrated to be an effective approach to treating migraine.[1]
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Symptomatic control to abort attacks

Migraine sufferers usually develop their own coping mechanisms for intractable pain. A cold or hot shower directed at the head, a wet washcloth, less often a warm bath, or resting in a dark and silent room may be as helpful as medication for many patients, but both should be used when needed. A simple treatment that has been effective for some, is to place spoonfuls of ice cream on the soft palate at the back of the mouth. Hold them there with your tongue until they melt. This directs cooling to the hypothalamus, which is suspected to be involved with the migraine feedback cycle, and for some it can stop even a severe headache very quickly.

For patients who have been diagnosed with recurring migraines, doctors recommend taking painkillers to treat the attack as soon as possible. Many patients avoid taking their medications when an attack is beginning, hoping that "it will go away". However in many cases once an attack is underway, it can become intensely painful, last for a long time (sometimes even for several days), and become somewhat resistant to medical treatment. In contrast, treating the attack at the onset can often abort it before it becomes serious, and can reduce the frequency of subsequent attacks in the near-term.

The first line of treatment is over-the-counter abortive medication. Doctors start patients off with simple analgesics, such as paracetamol (known as acetaminophen in the U.S.), aspirin and caffeine. They may provide some relief, although they are not effective for most sufferers. Some patients find relief from taking Benadryl or anti-nausea agents.

Narcotic pain killers (for example, codeine, morphine or other opiates) provide variable relief, but their side effects, the possibility of causing rebound headaches or analgesic overuse headache, and the risk of addiction contraindicates their general use.

If over-the-counter medications do not work, the next step for many doctors is to prescribe fioricet or fiorinal, which is a combination of butalbital (a barbiturate), acetaminophen (in fioricet) or acetylsalicylic acid (more commonly known as aspirin and present in fiorinal), and caffeine. While the risk of addiction is low, butalbital can be habit-forming if used daily, and it can also lead to rebound headaches.

Anti-emetics by suppository or injection may be needed in cases where vomiting dominates the symptoms. The earlier these drugs are taken in the attack, the better their effect.

Until the introduction of sumatriptan (Imitrex®/Imigran®) around 1985, ergot derivatives (see ergoline) were the primary oral drugs available to abort a migraine once it is underway. However, ergotamine tablets (usually with caffeine), though sometimes effective, have fallen out of favour. Absorption is erratic unless taken by suppository or injection. Dihydroergotamine (DHE), which must be injected or inhaled, can also be effective. These drugs can be used either as a preventive or abortive therapy.

Sumatriptan and related selective serotonin receptor agonists are now the therapy of choice for severe migraine attacks that cannot be controlled by other means. They are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70-80% of patients. Some patients have a recurrent migraine later in the day, and only one such recurrence in a day can be treated with a second dose of a triptan. They have few side effects if used in correct dosage and frequency. There have been some rare instances of cardiac arrest in patients using triptans. Some members of this family of drugs are:

* Sumatriptan (Imitrex®, Imigran®)
* Zolmitriptan (Zomig®)
* Naratriptan (Amerge®, Naramig®)
* Rizatriptan (Maxalt®)
* Eletriptan (Relpax®)
* Frovatriptan (Frova®)
* Almotriptan (Almogran®)

Evidence is accumulating that these drugs are effective because they act on serotonin receptors in nerve endings as well as the blood vessels. This leads to a decrease in the release of several peptides, including CGRP and Substance P.

These drugs are available only by prescription (US, Canada and UK) although Sumatriptan is to be available in the UK over the counter from mid-June, 2006. [2] It is also expected to become eligible for generic status in the United States in 2007. Many migraine sufferers do not use them only because they have not sought treatment from a physician.

Regarding comparative effectiveness of these drugs used to abort migraine attacks, a 2004 placebo-controlled trial (Cephalalgia. 2004 Nov;24(11):947-54) reveals that acetylsalicylic acid, sumatriptan and ibuprofen are equally effective.

Triptan therapy has been shown to result in a reduction in lost productivity. Sumatriptan has been shown to result in an average of 0.5 fewer missed workdays during the first three months of therapy and 0.7 fewer missed workdays within the first six months, as well as a reduction in the number of days spent working while symptomatic. The average reduction in lost productivity has been estimated at $1,249, at a cost of $25 per day of disability avoided. The annual net savings in reduced health care costs and lost productivity, over the increased cost of triptan therapy, has been estimated at between $114 and $540 per patient; thus the use of these pharmaceuticals represents a cost savings as well as an improvement in the patients’ quality of life.
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Preventive drugs

Patients who have more than two headache days per week are usually recommended to use preventatives and avoid overuse of acute pain medications.

Preventive medication has to be taken on a daily basis, usually for a few weeks, before the effectiveness can be determined. It is used only if attacks occur more often than every two weeks. Supervision by a neurologist is advisable. A large number of medications with varying modes of action can be used. Selection of a suitable medication for any particular patient is a matter of trial and error, since the effectiveness of individual medications varies widely from one patient to the next.

The most effective prescription medications include several classes of medications including beta blockers such as propranolol and atenolol, antidepressants such as amitriptyline, and anticonvulsants such as valproic acid and topiramate.
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Alternative approaches

Because the conventional approaches to migraine prevention are not 100% effective and can have unpleasant side effects, many seek alternative treatments.
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Physical therapy

Many physicians believe that exercise for 15-20 minutes per day is helpful for reducing the frequency of migraines. [3] (PDF)

Massage therapy and physical therapy are often very effective forms of treatment to reduce the frequency and intensity of migraines. However, it is important to be treated by a well-trained therapist who understands the pathophysiology of migraines. Deep massage can 'trigger' a migraine attack in a person who is not used to such treatments. It is advisable to start sessions as short in duration and then work up to longer treatments.

Chiropractic adjustments to the upper cervical spine are very effective in treating migraine headaches. There is research to support these claims. One study found that the upper cervical adjustment was just as efective as drug therapy for chronic cases. It is also noted that routine spinal adjustments help prevent the frequency, duration, and intensity of the headaches.[citation needed]
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Prism eyeglasses

At least two British studies have shown a relationship between the use of eyeglasses containing prisms and a reduction in migraine headaches.

Turville, A. E. (1934) Refraction and migraine. Br. J. Physiol. Opt. 8, 62-89, contains a good review of the literature and theories existing in 1934, and includes the vascular theory of migraine that is popular today. In that study, Turville suggests that many patients were provided with complete relief from migraine symptoms with proper eyeglass prescriptions that included prescribed prism.

Wilmut, E. B. (1956) Migraine. Br. J. Physiol. Opt. 13, 93-97, replicated Turville's work. Both studies are subject to criticism because of sample bias, sample size, and the lack of a control group.

Neither study is available online, but another study which found that precision tinted lenses may be an effective migraine treatment and which references the Turville and Wilmut studies can be found here. [4] (PDF)

Turville's and Wilmut's conclusions have largely been ignored since 1956 and it is widely believe that vision problems are not migraine triggers. However, a casual search of the usenet archives maintained by Google Groups shows many anecdotal reports demonstrating a relationship between migraines and eyeglasses. [5]

Most optometrists avoid prescribing prism because, when incorrectly prescribed, it can cause headaches. Prism has been proven effective at relieving motion sickness, which itself has many symptoms that are similar to the aura that accompanies migraine.[6]
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Herbal and nutritional supplements

50 mg or 75 mg/day of butterbur (Petasites hybridus) rhizome extract was shown in a controlled trial to provide 50% or more reduction in the number of migraines to 68% of participants in the 75 mg dose group, 56% in the 50 mg dose group and 49% in the placebo group after four months. Native butterbur contains some carcinogenic compounds, but a purified version, Petodolax®, does not.[citation needed]

Cannabis was a standard treatment for migraines from the mid-19th century until it was outlawed in the early 20th century in the USA. It has been reported to help people through an attack by relieving the nausea and dulling the head pain. There is some indication that semi-regular use may reduce the frequency of attacks. Further studies are being conducted.

Supplementation of coenzyme Q10 has been found to have a beneficial effect on the condition of some sufferers of migraines. In a well-controlled trial, Young and Silberstein found that 61.3% of patients treated with 100 mg/day had a greater than 50% reduction in number of days with migraine, making it more effective than most prescription prophylactics. Fewer than 1% reported any side effects. [7]

The plant feverfew (Tanacetum parthenium) is a traditional herbal remedy believed to reduce the frequency of migraine attacks. Clinical trials have been carried out, and appear to confirm that the effect is genuine (though it does not completely prevent attacks).

Kudzu root (Pueraria lobata) has been demonstrated to help with menstrual migraine headaches and cluster headaches. While the studies on menstrual migraine assumed that kudzu acted by imitating estrogen, it has since been shown that kudzu has significant effects on the serotonin receptors. Kudzu Monograph at Med-Owl.

Magnesium citrate has reduced the frequency of migraine in an experiment in which the magnesium citrate group received 600mg per day oral of trimagnesium dicitrate. In weeks 9-12, the frequency of attacks was reduced by 41.6% in the magnesium citrate group and by 15.8% in the placebo group.[8]
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Non-drug medical treatments

Botox has been used by some sufferers in an attempt to reduce the frequency and/or severity of migraine attacks (Botox for Migraines).

Spinal cord stimulators are an implanted medical device sometimes used for those that suffer severe migraines several days each month[5].
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Other alternatives

Some migraine sufferers find relief through acupuncture which is usually used to help prevent headaches from developing. Sometimes acupuncture is used to relieve the pain of an active migraine headache. In one controlled trial of acupuncture with a sham control in migraine, the acupuncture was not more effective than the sham acupuncture but was more effective than delayed acupuncture.

Biofeedback has been used successfully by some to control migraine symptoms through training and practice.

Diet, visualization, and self-hypnosis are also important alternative treatments and prevention approaches.

Bruxism, clenching or grinding of teeth, especially at night, is a trigger for many migraineurs. A device called a nociceptive trigeminal inhibitor (NTI) takes advantage of a reflex limiting the force of clenching. It can be fitted by dentists and clips over the front teeth at night, preventing contact between the back teeth. It has a success rate similar to butterbur and co-enzyme Q10. Massage therapy of the jaw area can also reduce such pain.

Answer 2

i get migraines also and what usually causes mine is stress or being over tired.. i usually take a sleeping pill and knock myself out for the night and if i still have it when i wake up i take some pain pills. i hate getting them also i always get so sick with them and i can't stand the light or sound and god forbid if anyone tries talking to me i am like a mad woman! i can't sleep and forget about even moving! i was put in the hospital many times for them to give me shots because i would take my sleeping pill and pain medication and i would have it for 3 4 days at a time! people tried being hypnotized and that needle crap and i think they got a new drug out that is supposed to prevent them ask Ur doctor he/she will tell you if the medication is any good or not.

i had to come back and say WOW it must have taken u a whole 5 min to copy that off line!

Answer 3

The exact cause of Migraine is unknown. It is thought, however, that an attack may be triggered by events that affect certain areas of the brain.
High levels of the chemical serotonin in the brain are believed to cause certain blood vessels to narrow (contract). This decrease in blood flow may be responsible for causing visual disturbances (auras).

When the levels of serotonin fall again, the blood vessels widen (dilate) causing pain
(or headache). Recovery follows as the blood vessels return to normal.

Triggers of a Migraine include emotional factors, physical exertion, certain foods, and some medications. Migraine can also be hereditary. Some people find they have a Migraine attack during a restful period (eg, during the weekend) or following a busy period, and others may feel either full of energy - or lacking energy - before the headache appears.

Women may also have Migraine attacks related to the hormonal changes caused by their menstrual period or pregnancy.

With all Migraine headaches, the trigger either changes levels of certain chemicals in the brain or how the body reacts to them.

Common triggers include:
Stress
Caffeine
Tiredness
Withdrawal of caffeine
Anxiety
Alcohol
Tobacco smoke
Cheese and other dairy products
Weather changes
Contraceptive pills
Chocolate
Menstruation
Some food additives (eg, aspartame,sodium nitrate)

There is no specific cure for Migraine, although some medications can help to alleviate pain and reduce the distressing symptoms of the attack.

Drugs may be prescribed either to relieve an existing attack or prevent one from happening in the future.

Avoiding the known triggers of an attack is also an important aspect of treatment.
The following drug types can be used to treat , prevent or relief the symptoms. ( please note the drug types are the chemical not trade names).

Anticonvulsants
Alter the activity of the chemicals within the brain responsible for spasm or relaxation of blood vessels.

Antidepressants
Alter the activity of chemicals within the brain responsible for spasm or relaxation of blood vessels.

Beta-Blockers
Exact mechanism of action is unknown. May help stabilize the blood vessels in the brain to prevent spasm.

Calcium Antagonists
May reduce the blood vessels' ability to contract in the initial stages of a Migraine attack.

Ergot Derivatives
Alter brain chemicals to decrease excessive blood flow of blood through the vessels in the brain.

NSAIDs
Decrease the inflammation which may contribute to pain.

Answer 4

They don't know either. I do not get headaches. I don't smoke or drink. My mother got terrible migraines and she was a chain smoker. She smoked since age 14.

Maybe there is a connection considering that the tobacco has additives like urea, main ingredient in urine; shelac; cadmium, poisonous chemical etc.

Answer 5

Evil spirits cause migraines. The best thing you can do is take a cold shower and make sure to run the cold water over your head and neck and back.

Answer 6

well, caffeine is like a drug,(not that it will kill you like crack or something) in your brain if you drink caffeine every day, your body starts to build up chemicals that give you that good awake feeling, when you do not drink caffeine your body goes throw withdraw symptoms(like if you try to stop drugs but not as bad) and when those chemicals in you brain get low you body who is used to them, starts to hurt and you feel like crap, that is why you get a migraine from not drinking coffee, that is your body telling you, hay you gave me caffeine every day, why did you not today. So how do you make that go away you drink more caffeine, and then those chemicals in your brain build up again, and you feel good again, it is the same way as if you are addicted to drugs, did you ever notice that the more days that you drink coffee the more you need to wake up the next day.

Answer 7

I can imagine the feeling!

There is a solution - enjoy a manual one-time treatment called Atlasprofilax. The effect on the self-healing power of your body is simply amazing, experienced it myself! :-)

Just - the treatment is available in California and Europe only, costing approx. 220 dollars. It's really worth travelling far!

Answer 8

wish i knew what caused them. i know vicadin and ice cream and a cold wash cloth on my head fixes them. your doctor can give you pills to stop them from completely forming when you feel one coming on, but i can't remember the name of that pill

Answer 9

marriage....stress....rules....society....bills.....get rid of them.....will get rid of migraines.....if that don't work...try marijuana....that always works!

Answer 10

i know that stress can trigger them. (see a dr.)

Answer 11

As a night shift worker, I sometimes experience this. One of my coworkers (a master's level registered nurse) recommended caffeine. I thought this ironic since some studies actually identify this as a culprit. nevertheless, she said, it works for her. She said in a migraine the blood vessels constrict and the caffeine helps them to relax. She offered me a "rocket chocolate" and desperate as I was at the time, was willing to try anything. It did work. Also found the following article on the 'net. Best wishes to you.

6/20/06 P.S. The other thing my coworker mentioned was fluid intake; drink water, juice and/or other fluids when the migraine comes on.

"Alice,

My wife has terrible migraine headaches. She has tried caffeine, vitamins, and Motrin. Motrin works occasionally. Any suggestions?

—Low tolerance



Dear Low tolerance,

There are three major types of headaches: tension (most common), vascular, and organic (rarest of the three that's associated with an underlying medical condition, such as a tumor, infection, disease, or hemorrhage). Migraines fall under the vascular headache category, which are due to constriction and then dilation of blood vessels in the head. Migraines are severe headaches, lasting from several minutes to several days, often accompanied by light and noise sensitivity, nausea, possible vomiting, and sometimes disturbances of vision (known as auras, which include flashing lights and blind spots). According to the Journal of the American Medical Association (JAMA) Migraine Information Center, migraines affect approximately twenty-six million Americans, nearly 75 percent of whom are women. Occasionally, people experience only a single migraine; more typically, however, they have recurrent episodes at varying intervals.

Migraines seem to run in families. It is believed that migraines can be caused by biochemical changes in the brain, particularly a low level of the neurotransmitter, serotonin. People with migraines do not have enough serotonin to quiet the body's response to various triggers, such as:

certain foods
strong smells
excessive hunger
changes in altitude, weather, or temperature
bright lights
rising or dropping stress levels
sleep difficulties
depression
extreme noise
in some women, hormonal fluctuations, particularly estrogen, that accompany menstruation, birth control pills, pregnancy, and estrogen replacement therapy

Migraines come in two types: common and classic. In common migraines, which affect about 80 percent of people with migraines, the pain of the headache develops slowly, sometimes mounting to a throbbing pain that is made worse by the slightest movement or noise. The pain is often, but not always, on one side of the head only, and usually occurs with nausea and sometimes vomiting (many recover after they have vomited). The difference between common and classic migraines is that classic ones are accompanied by auras. Most people find that they recover more quickly from a migraine if they can sleep in a darkened, quiet room and use an ice pack.

The best-known prevention of migraine headaches is to avoid any known triggers. What may bring about one migraine may not necessarily give rise to others, which could be caused by other trigger(s). Keeping a careful diary can help pinpoint triggers, including certain foods or ingredients, such as:

alcoholic beverages (often those containing sulfites, such as red wine)
aged cheeses (because they have tyramine)
chocolate
citrus fruits
fermented products
monosodium glutamate (MSG)
preserved meats (due to nitrates and nitrites)
possibly aspartame

These may need to be limited or cut out of the eating plan as they have been implicated in setting off migraines in many people. Managing stress levels, treating any underlying depression, quitting smoking (if already a smoker), limiting salt and caffeine intake, and following regular eating, exercise, and sleep schedules can also help. Not having enough sleep or oversleeping is a common cause of migraines. Try getting up at the same time each day. If it's the weekend, regardless of bedtime, arise at the usual time anyway, have something to eat, wash up, and then go back to bed or take a nap later on in the day. Relaxation, physical therapy, and massage can help the migraine affected as well.

If making lifestyle changes is not enough in managing migraine episodes, then this person will need to see a health care provider to discuss more powerful treatment options and what'll work best for him or her, including trying different medications to see what's effective or alternating between two or more meds depending on the type of migraine s/he has. Follow directions carefully and avoid overmedicating and overusing (i.e., chronic or daily use) pain relievers, which could lead to rebound headaches as the last dose leaves the system:

As a first step in treating mild migraine pain, someone can try an over-the-counter (OTC) analgesic, such as acetaminophen, aspirin, ibuprofen, naproxen sodium, and ketoprofen, at the first signs of a migraine. An aspirin, acetaminophen, and caffeine combination, such as Excedrin Migraine, is also available, which is the first OTC product approved by the U.S. Food and Drug Administration (FDA) for treating mild to moderate migraines. Aspirin helps relieve pain, lessen inflammation, and decrease platelet aggregation. Caffeine enhances the effectiveness of the other two drugs. However, recent research suggests that an overuse of these medications can actually exacerbate the problem rather than fix it. If one is taking numerous doses of these pills a day, talk with a primary care provider about other treatment options and possible complications.

For more moderate migraine pain, a combination of a narcotic pain reliever and aspirin or acetaminophen could be taken as long as episodes are not recurrent, since a person can develop a dependency to these drugs. Another option is aspirin or acetaminophen plus a sedative, which is relaxing but also may be habit-forming.

For moderate to severe migraines, ergot alkaloids (e.g., ergotamine, dihydroergotamine), an alternative to analgesics that constricts the dilated blood vessels surrounding the brain, can be considered. Also available for the treatment of acute episodes are the triptans, which are serotonin agonists (see below for more information), and isometheptene-acetaminophen-sedative mixtures for pain relief, relaxation, and blood vessel narrowing.

For migraine prevention, there are beta-blockers, calcium channel blockers, antidepressants, serotonin antagonists (e.g., methysergide), and anti-seizure meds (e.g., divalproex sodium), all of which can help decrease the number, duration, and severity of migraines. These drugs are recommended for people who have at least two incapacitating migraines a month or who have such severe episodes that daily life routines are disrupted.

Some people have been able to treat their migraines without drugs through a method known as biofeedback. With biofeedback, a person learns how to manage both muscle tension and blood vessel constriction and dilation that are often involved in the development of a migraine.

Anti-nausea, or anti-emetic, meds could also be considered to help relieve the nausea and possible vomiting symptoms that can accompany migraine pain.

Much progress has been made recently in the field of migraine therapy. Powerful new drug offerings have made a dramatic difference in improving the quality of life of many people who have acute or chronic migraines, in particular, and who have not had much success, or who had too many intolerable side effects, with past treatment options. One such medication is the triptans (e.g., sumatriptan, naratriptan, rizatriptan, and zolmitriptan), which are available in several forms depending on how quickly someone wants the drug to act on his or her migraine. From slowest to fastest acting, there are pills taken by mouth, nasal sprays, and self-injectable forms. A 5-HT agonist, sumatriptan, has received a lot of attention and is the most commonly taken triptan. Sumatriptan is a migraine abortive medication that binds to 5-HT receptors on the trigeminal nerve for serotonin, which then stops the migraine from progressing. Side effects, such as chest tightness, warmth, and dizziness, are mild and fleeting in most people. Depending on a person's medical history and what drugs and supplements s/he is currently taking, a health care provider will determine whether or not s/he can take sumatriptan. Unfortunately, sumatriptan pills are priced at around fourteen dollars each and injectable forms can cost about forty-two bucks. And, it doesn't work for everyone.

Considering there are more migraine treatment options than ever before, your wife could benefit from seeing a health care provider to get a proper diagnosis of what she has and to discuss her prescription possibilities. She can work with her provider in coming up with a migraine management plan that'll meet her needs and be effective for her. Hopefully she'll find some more lasting relief soon.

For more information about migraines, check out:

National Headache Foundation
An information resource providing written information, physician names for treatment through the mail, educational materials, and membership (for a nominal fee).
Headache Hotline: 1.888.NHF.5522 [9 AM - 5 PM (CT), M - F]
E-mail: [e-mail]

American Council for Headache Education (ACHE)
A non-profit physician-patient partnership to advance headache prevention and treatment.
Phone: [phone]
E-mail: [e-mail]

Alice"