How sudden migraine attacks are treated with drugs

Migraine is the second most common cause of all headaches. It affects around 15% of women and 6% men (Harrison 17th). It usually occurs episodically and sudden attack is characterized by throbbing and unilateral (one side of the head) headache. In addition, migraine pain is aggravated by movements and it is associated with nausea, vomiting, photophobia (sensitivity to light) and phonophobia (sensitivity to sound).

What are the other features of sudden migraine attacks?

In addition to above features, sudden migraine attacks can cause lightheadedness, visual disturbances such as fortification spectra, numbness, vertigo, diarrhea and confusional state.

How sudden migraine attacks are treated?

These attacks are treated with pain killers, serotonin agonists, and dopamine antagonists. There are numerous types of medications that can be used in above categories. Most of them can be given through oral route, but some can be administered through nasal and intravenous routes.

Medications that are given in sudden migraine attacks

NSAIDS are the commonest type. E.g. are Motrin, Naprosyn and Voltaren given in sudden severe migraine. However, they can cause gastric irritation as a side effect. In addition, acetaminophen (paracetamol) can be given as a mild pain killer with minimal side effects.

Common serotonin agonists used in sudden migraine attacks are ergotamine and Sumatriptan. They can be given through nasal, intravenous or oral route.

In addition, sudden migraine attacks can be treated effectively with dopamine antagonists such as Maxalon, Largactil and Stematil. These medications are usually available as oral and intravenous forms. These drugs have an additional property of treating nausea and vomiting.

Intravenous and nasal route are preferred when the patient has intractable vomiting. In addition, intravenous drugs can be given in sudden severe attacks to get an immediate pain relief.

Side effects of Medications used in migraine

Most of the above medications can cause side effects such as nausea, vomiting, gastric irritation, abnormal movements, and drowsiness and sleep disturbance. Therefore, in a severe migraine attack drugs should be given by a doctor who has experience in handling migraine.

Medication overuse headache

This is a complication of drug treatment of sudden severe migraine headache. Sometimes overuse of drugs can cause severe rebound headache as a side effect.

Conclusion

Sudden severe migraine headache is a very unpleasant problem. However, it can be treated effectively with medications. But these medications can also cause side effects and rebound headache. Therefore, an experienced doctor should manage acute severe migraine attacks.

Sources

Harrison’s principles of internal medicine 17^th edition

Disclaimer and warning

This health related article is written by a Medical doctor and it is for information only. You should consult your doctor before starting or stopping any prescription medication. Even though, Medical information included in this article are current, they may change without notice.