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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.

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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.Tramadol is also found by many migraines sufferers to relieve pain quickly pain and is used due to its compatibility with aspirin and similar drugs and the many types of forms it is available in.

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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