As headaches go, migraines are in a league of their own.
Migraines typically produce pulsating pain on one side of the head. That can lay you low for up to 72 hours.
About 20% of people with migraines have headaches preceded by aura, which can include:
Blind spots or zigzags in your field of vision
Aura may also include numbness or tingling on one side of the body. Aura without head pain is also a form of migraine.
Migraines are often prompted by one...
You have moderate-to-severe headache pain that is disabling and interfering with your life despite treatment.
You have at least three moderate-to-severe headache days per month.
Your migraines are seriously affecting your quality of life.
You are taking migraine painkillers very frequently.
Your current migraine drugs are not providing sufficient relief.
You are having side effects from current headache drugs.
You prefer to take a preventive approach.
You don't mind taking a daily medication.
You have uncommon migraine conditions, like prolonged aura.
Migraine Prevention Drugs Are Usually Not Used If:
You have mild-to-moderate pain that is not disabling.
You have less than three moderate-to-severe headache days per month.
Your headaches are controlled by drugs like NSAIDS (anti-inflammatories like Aleve or Motrin) or triptans.
You don't have side effects from those drugs.
You don't take those drugs frequently.
You're not ready to take a daily migraine medication.
You have other health conditions that do not allow you to take preventive drugs.
You cannot tolerate side effects of preventive drugs.
There might be negative drug interactions with other medications you are taking.
You prefer a non-drug treatment (like biofeedback).
If you can't take medication or prefer not to, a device may be worth considering. Cefaly is the first FDA-approved device for preventing migraines in people over age 18. The portable headband-like device gives electrical impulses on the skin at the forehead. This stimulates a nerve associated with migraine headaches. Cefaly is used once a day for 20 minutes, and when it's on you'll feel a tingling or massaging sensation.
Migraine Drugs and Pregnancy
If you are pregnant or want to get pregnant, here's good news: Your migraines may ease up during the second and third trimester of pregnancy.
However, if you have severe migraines, doctors may advise first trying a non-drug approach such as biofeedback, relaxation therapy, or stress-management training . Or your doctor may suggest trying those approaches along with a preventive drug therapy that has the lowest risk possible.
Talk to your doctor about your thoughts on taking preventive medications for migraines. Together, you can decide the best approach for your headache problems.
American Academy of Neurology: Evidence-Based Guidelines for Migraine Headache.
George R. Nissan, DO, director of research, Diamond Headache Clinic, Chicago.
News release, FDA.
Richard Senelick, MD on October 01, 2014
This tool provides general information and
recommendations, and may not address specific individual circumstances. Do not
rely on it exclusively to make decisions about your health. Always consult your
doctor for personal medical advice.