The treatment of migraine varies, depending on the frequency and severity of symptoms. Most patients find that resting in a quiet, darkened room can reduce the severity of symptoms. Drinking a lot of fluids is important, especially if there is vomiting. Nausea can be treated with anti-emetics.
Over-the-counter analgesics may reduce pain if they are taken early in the development of the headache. Many patients with mild migraines only need medications like acetaminophen, ibuprofen, or aspirin to treat their headaches. Medications that constrict the arteries inside the head (such as ergotamine tartrate preparations) may be used alone or in combination with other drugs such as caffeine (Cafergot), acetaminophen, and mild sedatives.
A class of drugs called triptans are also effective in the treatment of migraine. Various drugs from this class are available as self-administered injections under the skin, pills, tablets that dissolve in the mouth, and nasal sprays. These tend to be more effective if given at the beginning of a migraine.
Another strategy for migraine treatment is using medications that reduce the frequency of the headaches. These drugs are not helpful once the headache begins. Most of these medications were designed for use in other medical problems, but they are effective in preventing migraines in some patients. These medications include various beta-blockers, calcium channel blockers, anti-depressants, anti-epilepsy drugs, and various combinations of such drugs. Several medications may need to be tried before a medication that is effective in preventing migraine is found. The use of botulinum toxin has gained more recognition as a migraine prevention treatment.
Modifying diet, sleep habits and other personal activities may also reduce the frequency of migraine headaches. Factors that have triggered a migraine in the past should be avoided whenever possible. A "headache diary" that lists diet, sleep pattern, stressful incidents, and other factors can help patients determine what their personal triggers are. Some women may find that birth control pills are a trigger for them and may wish to choose another form of contraception.
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