Pain/Inflammation: Migraine Headaches
Overview
Migraine headaches, often called migraines, are a common neurologic condition that can negatively impact an individual’s quality of life. According to the National Headache Foundation and the American Migraine Study, approximately 30 million individuals in the United States are affected by migraines. Migraines are most common among individuals aged 25 to 50 years, and migraines are 3 times more common in females than in males.

Signs and Symptoms
The most common symptom associated with migraines is a throbbing pain on 1 side of the head. The signs and symptoms vary among individuals and may include:
  • Nausea
  • Vomiting
  • Blurred vision
  • Sensitivity to light, smell, and sound
  • Dizziness
  • Fatigue

Cause and Common Triggers
While the exact cause of migraines is not known, several triggers have been identified, including:
  • Stress
  • Fatigue
  • Anxiety
  • Changes in weather, altitude, and/or air pressure
  • Hormonal changes such as during a menstrual cycle or pregnancy
  • Environmental factors such as noise, bright lights, or certain odors
  • Consumption of vasoactive substances in certain foods, such as nitrates, tyramine (eg, in aged cheese) red wine, and monosodium glutamate
  • Alcohol consumption
  • Use of certain pharmacologic agents, such as nitrates, oral contraceptives, nifedipine, and postmenopausal hormones
  • Changes in sleep or eating patterns.

Testing and Diagnosis
If you suspect you are having a migraine headache, your doctor will review your medical history and symptoms as well as conduct physical and neurologic exams. Other medical tests may be ordered to rule out other medical conditions.

Prevention
The best way to prevent migraines is to take your medication at the first sign of a migraine or before being exposed to a known trigger. Several lifestyle modifications may reduce the frequency and severity of migraines, including:
  • Avoiding known triggers when possible
  • Exercising regularly
  • Taking medications as directed

Management
You can ease the pain and discomfort associated with migraines by:
  • Getting sufficient sleep
  • Keeping a headache diary to determine your headache triggers
  • Resting and relaxing when possible, and reducing stress

Treatment and Care
Medications used for managing migraines are typically classified as preventive medications or pain-relieving medications. Treatment is determined by the frequency and severity of your migraines, the cause of your migraines, and your other medical conditions.

Homeopathic and Alternative Remedies
Many individuals may elect to use alternative remedies for migraine prevention and relief, including:
  • Acupuncture
  • Biofeedback
  • Herbs, vitamins, and minerals, such as butterbur, feverfew, Coenzyme Q10
  • Stress management techniques

Self-Care
Several OTC products are marketed for the treatment of mild to moderate migraines. These products contain analgesics such as acetaminophen (APAP), ibuprofen, and aspirin (ASA), as well as caffeine. Self-treatment of migraines is only recommended after a diagnosis has been confirmed. To prevent drug interactions, contraindications or adverse reactions, it is important to discuss the use of these products with your doctor or pharmacist before using them.

Resources for Patients
My Chronic Migraine
Medline Plus
National Headache Foundation

Resources for Pharmacists
National Headache Foundation
American Headache Society
My Chronic Migraine for Healthcare Professionals
American Pain Society
Migraine Research Foundation

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