Hello again everyone! It’s Beth, one of your Pharmacy Chicks. June is Migraine and Headache Awareness Month. A headache is pain in any part of the head. They may happen on one or both sides of the head, be isolated to one location or radiate across the head or feel like a vise. A headache may be a sharp pain, throbbing, or a dull ache. They can develop gradually or suddenly and may last for less than an hour to days.
A migraine is a type of headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. Nausea, vomiting, dizziness, and sensitivity to light and sound often accompany migraine. Migraines can interfere with performing daily activities.
There are four potential stages of migraine. Not everyone that has migraines goes through all stages. The stages are prodrome, aura, migraine attack, and the post-drome. The prodrome stage involves changes that may warn of an upcoming migraine. These may include constipation, mood changes, food cravings, neck stiffness, fluid retention, increased urination, or frequent yawning. An aura can occur before or along with the headache. This aura may be visual disturbances (flashes of light or blind spots), dizziness, difficulty speaking, or tingling on one side of the face, arm, or leg. A migraine attack usually lasts from a few hours to three days when untreated. They may happen a couple of times a year or several times a month. The final stage is the post-drome, the after-effects. After a migraine, there may be a feeling of being drained, confused, or elated. Sudden head movements may briefly cause the pain to return.
We don’t really understand what causes a migraine, but genetics and environmental factors seem to be involved. There is thought that changes in the brainstem and interactions with the trigeminal nerve, which gives sensation to the head and face, may be involved. The body is cued to release neurotransmitters, such as serotonin and calcitonin gene-related peptide (CGRP). CGRP is primarily released from the sensory nerves and is a vasodilator (dilates the blood vessels). These changes in blood flow and the neurotransmitters can cause inflammation and pain.
There are several potential triggers of migraine. These include hormonal changes, drinks (alcohol and excessive caffeine), stress, sensory stimulus (flashing lights, loud sounds, or strong smells), sleep changes (missing sleep or too much sleep), weather changes, foods (aged cheese, salty or processed foods), skipping meals, food additives (especially aspartame and MSG), and medications (oral contraceptives and vasodilators). People with a family history of migraines have a greater risk of developing migraines. Women are also three times more likely than men to have migraines.
Medication-overuse headaches can happen when medicines used to treat migraines stop relieving pain and may cause rebound headaches. This can happen with combination medications that contain butalbital, aspirin, acetaminophen, or caffeine. Overuse headaches may also happen if you take triptan medications (like sumatriptan, rizatriptan, zolmitriptan, frovatriptan, or eletriptan) for more than nine days a month.
There are lifestyle remedies and nontraditional therapies that can be used to prevent and soothe migraine pain. When a migraine begins, a quiet, dark room may help to relieve symptoms. Closing the eyes or taking a nap, placing a cool cloth or covered ice pack on the forehead, and drinking water may also help. There are other techniques that can be used to prevent or reduce migraine pain. These include:
•Relaxation techniques (such as meditation and yoga) to reduce stress
•Follow a regular sleep and wake routine (avoid too little or too much sleep)
•Follow a regular meal routine
•Exercise regularly, including aerobic exercise with slow warm-ups
•Herbs, vitamins, and minerals
Keeping a headache dairy will help you to learn your personal migraine triggers and what treatments may be most effective for you. Maintaining a healthy body weight may also reduce migraine.
Medications may be used to prevent migraine attacks or stop symptoms. Preventive medications try to reduce the frequency of migraines, their severity and length. These can include blood pressure-lowering medications (beta blockers such as propranolol and metoprolol), antidepressants such as amitriptyline, anti-seizure drugs such as topiramate and valproic acid, Botox injections, and CGRP monoclonal antibodies (such as Aimovig, Ajovy, Emgality, Qulipta, and Vyepti). Medications for relief of symptoms work best when they are taken at the first sign of a migraine. These medications can include over-the-counter pain relievers (such as aspirin, ibuprofen, naproxen, or combination aspirin/acetaminophen/caffeine), triptans, Lasmiditan (Reyvow), CGRP antagonists (Ubrelvy and Nurtec ODT), anti-nausea drugs, and opioid or barbiturate medications (including butalbital-containing products). These medications may have unwanted side effects and may not be safe to take during pregnancy. Talk with your pharmacist before beginning any new medication about any possible interactions with your current medications or health conditions.
Always remember that your pharmacist is a resource, along with your healthcare provider, for helping you understand the importance of your medications and your health conditions. You can always stop by and see me at Sparta Drug Center or Jennifer at Payless Family Pharmacy with questions. Pharmacy Chicks out!
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