Is Your Migraine Treatment Working?
With a battalion of drugs to cut migraine frequency, are you making progress in your migraine treatment?
Taking Control of Your Migraine Treatment
The process of finding the right drugs and dosages takes time, explains
Nissan. "It's not an exact science. There's no cookbook approach. There are
no absolutes. And there are a lot of options. Some patients respond to multiple
drugs; some respond to only a few."
A headache specialist will start with one drug, keep the initial dosage low,
and gradually increase it or change medications. The patient keeps a headache
diary to track the treatment's effectiveness and side effects.
Typically, patients take a drug for two to three months to test the effect,
Nissan says. How do you know you're on the right track?
"Often, the goal is to drop down to one or two headaches a month,"
he tells WebMD. "We can achieve that with many patients. With others, we
will achieve some reduction -- but we might not get 50%."
Once migraine frequency is under control, it may be possible to taper off
preventive medication, Nissan notes. "Patients have to be very stable, with
little or no headache," he says. Once they are stable they can transition
to using a migraine stopper medication for the occasional migraine, adds
Nissan. Unfortunately, a lot of people don't fall into that category.
What You Can Do to Treat Migraines
Medications can't do all the work of stopping migraines, says Nissan.
Patients must change habits and coping patterns that feed the migraine cycle,
Stress reduction: Learning a few stress-reduction
techniques can be a great help, studies show. Biofeedback is a means of
training yourself to control physical reactions to stressful situations.
Relaxing: Relaxation training can help you control muscle
tension and learn to mentally relax.
Sleep & exercise: Getting a good night's sleep and
exercise are each important in themselves, but can also aid in reducing stress
and promoting relaxation.
Diet: Sticking with a "headache diet" is also
critical, Nissan adds. That means steering clear of foods and beverages that
trigger your migraines, such as:
- Ripened cheeses
- Alcoholic beverages
- Preserved meats (like hot dogs)
Keeping a headache diary helps you identify these and other common
Therapies: "Some patients may benefit from
psychological therapy, if there are emotional problems like depressiondepression or anxiety," Nissan says. Some
evidence suggests that acupuncture could also help prevent migraines.
"These are all ways of regulating the body so you're not triggering
migraines," Nissan tells WebMD.
Measuring Migraine Treatment Success
Follow all these suggestions, and you are likely to achieve success, says
Goldstein. "For the chronic migraine sufferer, there is an element of trial
and error in finding what works best. But there is very likely to be
significant improvement -- up to 60%-80% reduction in headaches."
Published May 15, 2006.