Options to prevent pounding pain

Migraines are more than a bad headache. As nearly 30,000,000 Americans can attest, the throbbing pain of a migraine can be debilitating, lasting from a few hours to several days. The condition can be aggravated by light, sounds, odors, exercise, and even routine physical activities. Nausea, with or without vomiting, may occur, point out neurological researchers at the Mayo Clinic, Rochester, Minn.

Doctors sometimes recommend preventive medications for patients who have two or more debilitating episodes a month. Typically, the medication is taken at regular intervals, often daily. Antidepressants, anti-seizure medications, and cardiovascular drugs may help prevent migraines as well. Infrequently, nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium, may help. Injections of botulinum toxin type A (Botox) is an alternative for those who cannot take or do not respond well to preventive medications. However, this use of Botox for migraine prevention is not approved by the Food and Drug Administration.

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Pain relief drugs for migraines should be taken as soon as symptoms begin. Mild migraines may respond to NSAIDs, aspirin, or a nonprescription combination of a drug containing acetaminophen, aspirin, and caffeine. Other drug categories used to treat pain include triptans, which mimic the action of the brain chemical serotonin; antinausea and related drugs; and ergots, which were used for decades before the more recent introduction of triptans.

Some patients find relief from alternative therapies. The National Institutes of Health, Washington, D.C., has concluded that acupuncture may help control headaches. A study in Headache demonstrates that a combination of yoga, breathing exercises, and relaxation techniques reduces migraine frequency and pain.

Some find benefit in herbal remedies, such as butterbur, which appears to be safe if taken for a short period. In addition, the supplement coenzyme Q10 seems to be effective at reducing migraine frequency for some. Patients who consider alternative therapies should consult with their physician about the pros and cons and to prevent any drug interactions.

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