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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, including:

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
  • Caffeine
  • Alcoholic beverages
  • Preserved meats (like hot dogs)

Keeping a headache diary helps you identify these and other common culprits.

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.

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Reviewed on May 15, 2006
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