Migraine: Medications to Prevent Migraine
Francis S. Greenspan, M.D.
Chief, Thyroid Clinic, Member Division of Endocrinology and the
Department of Medicine
University of California, San Francisco
Lawrence C. Wood, M.D.
Associate Physician, Massachusetts General Hospital
CEO and Medical Director, Thyroid Foundation of America.
Migraine is a peculiar type of headache that tends to occur with
increased frequency in thyroid patients. The symptoms often begin
as a one sided headache with nausea, visual disturbances, and possible
other neurological symptoms.
Neurologists have learned that the best approach for patients with
migraine is to try to prevent the attacks from happening in the
first place. In some patients this can be accomplished by avoidance
of particular triggers such as alcohol, nuts, and chocolate. For
other patients asprin and two cups of coffee may arrest the attack
and clear up a mild headache if taken early enough.
But if that isn’t satisfactory, your physician will probably
start you on a program to prevent migraine using some or all of
a three pronged approach to prevention.
- An anti-inflammatory medication such as aspirin, Naprosyn, or
Motrin
- A beta blocker used to dilate blood vessels such as Atenolol
or Toprol
- Amitriptyline or another tricyclic antidepressant
Many patients are given a combination of these medications to
take everyday may experience a marked reduction or complete cessation
of migraine episodes.
The next step involves treatment of an attack which may be severe
and associated with vomiting and profound inability to function
at all. Medications used include Imitrix, Maxalt, and Zomig. Imitrix
works unless you are vomiting and cannot swallow the medication.
Zomig and Maxalt have the advantage of dissolving in your mouth
with absorption of the medication through your mucous membranes.
Therefore, their absorption is less affected by vomiting.
Above all, if you have migraine or one of the other conditions
being described please don’t try to manage this yourself,
but discuss various alternatives of management with your physician.
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