 Migraine headaches are those that last between 4 and 72 hours and come with nausea, vomiting, or increased sensitivity to lights or sounds. Some treatments for migraines work during the headache, while others prevent migraines from developing. Prescription drugs that work during migraine headaches include ergotamine (Ergomar), dihydroergotamine (>D.H.E., >Migranal), sumatriptan (>Imitrex), zolmitriptan (>Zomig), rizatriptan (>Maxalt, >Maxalt-MLT), naratriptan (>Amerge) and almotriptan >Axert. All of these drugs, except for dihydroergotamine, come in oral forms. Dihydroergotamine and sumatriptan are also available in injectable and nasal spray forms. The oral and nasal forms generally relieve headaches in 50 to 60 percent of people. Sumatriptan injection relieves headaches in 80 percent of people. Headaches come back within 24 hours in 30 to 40 percent of people who get relief from prescription drugs. Dihydroergotamine nasal spray is an exception: it reduces the recurrence of headaches to 20 percent. Sometimes, doctors use other medications, alone or in combination with those mentioned above, to treat migraine headaches. These include pain relievers such as morphine, meperidine (Demerol), ketorolac (>Toradol) or a combination medicine with isometheptene and acetaminophen (>Midrin) or butalbital, caffeine and acetaminophen (>Fioricet). Other helpful medicines added to lessen nausea and vomiting include chlorpromazine (>Thorazine) or metoclopramide (>Reglan). Take your medicine as soon as the headache starts, and repeat only as directed. You should feel the drug's effects within two hours after taking a dose. Daily use of these medicines can lead to migraines when you stop taking the drugs, or migraines that no longer respond to treatment. Drugs that can help prevent migraine headaches include propranolol (>Inderal LA), methysergide (>Sansert), amitriptyline (>Elavil), valproic acid (>Depakote), and verapamil (>Calan SR). These preventive therapies can reduce the number of migraine headaches by about 40 percent. Sources:
Silberstein, S.D., R.B. Lipton and P.J. Goadsby. Headache in Clinical Practice. Isis Medical Media, 1998.
Applied Therapeutics: The Clinical Use of Drugs. Applied Therapeutics, 1995.
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Visser, W.H. “Rizatriptan vs Sumatriptan In The Acute Treatment Of Migraine,” Archives of Neurology 53 (1996).
Touchon, J. A. “Comparison Of Subcutaneous Sumatriptan And Dihydroergotamine Nasal Spray In The Acute Treatment Of Migraine,” Neurology 47 (1996).
Holroyd, K.A. “Propranolol In The Management Of Recurrent Migraine: A Meta-Analytic Review,” Headache 31 (1991).
“Migraine Update” http://www.ninds.nih.gov/health_and_medical/pubs/migraineupdate.htm. National Institutes of Health .last accessed 8/9/01.
Micromedex Healthcare Series. Micromedex, Inc., 2001.
This answer prepared 8/9/01.
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