New Hope for Migraine Sufferers
Every patient and every migraine is different -- and should be treated as such. "Patients should tell doctors what they want and don't want with medications. Some are willing to accept more side effects to get rid of headache pain. Some are willing to accept more pain and discomfort as long as the medicine doesn't affect their ability to function."
As for medications, there is a wide variety for doctors to choose from -- to both prevent migraines and reduce disability and pain, says Silberstein. Most patients -- not all -- can be controlled with specific medicines like pain relievers such as Excedrin, Advil, or narcotics, or with drugs called "triptans," he says. "Not all pain medications work for all pain disorders."
Triptans are called "rescue medications" because they halt the kind of extreme pain that sends people to hospital emergency departments. Preventive medication, which is taken daily, "should be given for very frequent headaches or headaches which, despite acute treatment, produce disability."
When O'Connor finally was referred to Silberstein, "They took me off all the oral medications," she says. She found relief in an injectable medication that halts her migraines before they become full-blown.
"Migraine is not something you have to go to a super specialist for, although some patients may," David Hewett, MD, tells WebMD. "The guidelines are for emergency room and family physicians ... where migraine headaches are misdiagnosed a lot ... they will be a great boon to treatment, particularly in understanding [how to] individualize therapy." Hewett is assistant professor of neurology at Emory University School of Medicine in Atlanta.
"The biggest fear most people have is that it's a brain tumor, and that's where neurologists can be very helpful," says Hewett. "But I don't think there are enough neurologists in the country to handle all the migraine headaches that there are." Hewitt is also co-director of Emory's neurology, pain, and headache program.
"There are good medications to prevent headaches and great medications to stop headaches," he tells WebMD. "But instead of prescribing the newer drugs -- which can be very effective -- emergency physicians are quick to use [painkillers]," which don't last very long."