The Best Medications for Migraine Treatment and How to Prevent it?

At the end of a long, exhausting day, you may begin to feel a throbbing pain that covers almost half of your head. This pain is often preceded by unusual sensitivity to lights, sounds, or certain smells. Such is how a migraine attack typically begins, lasting for several hours before it subsides. Fortunately, migraines can be managed with a variety of medications. But what are the best migraine treatments? And how can you protect yourself from future attacks?

Causes of Migraine

Researchers have not yet identified the exact cause of migraine, but they believe that a combination of genetic factors, hormonal influences, and irregular brain activity all contribute to its development.

These factors affect nerve signaling, brain chemicals, and blood vessels. Women are three to four times more likely to experience migraines than men.

Migraine is often triggered by specific stimuli, such as certain foods or environmental changes. Common migraine triggers include:

• Bright lights
• Extreme heat or other harsh weather conditions
• Dehydration
• Hormonal changes in women, such as fluctuations in estrogen and progesterone during menstruation, pregnancy, or menopause
• Severe stress
• Loud noises
• Intense physical activity
• Skipping meals
• Changes in sleep patterns
• Certain foods
• Certain medications, such as birth control pills or nitroglycerin

Symptoms of Migraine

Migraines usually progress through several stages, with symptoms varying at each stage:

1. Prodrome (Pre-Migraine Stage)

Hours or days before the headache, about 60% of migraine sufferers experience warning symptoms such as:

• Sensitivity to light, sound, or smell that would not usually bother you
• Unexplained fatigue and frequent yawning
• Food cravings or loss of appetite, sometimes with a strong desire for sweets
• Mood changes, such as irritability or sadness
• Excessive thirst and frequent urination
• Digestive issues like bloating, constipation, or diarrhea

2. Aura

Up to 25% of patients experience what is known as "aura" shortly before or during the headache. These symptoms are often visual, begin gradually within 5–20 minutes, and usually last less than an hour. Symptoms may include:

• Visual disturbances, such as black spots, wavy lines, flashes of light, or tunnel vision
• Tingling or numbness in the face, hands, or limbs
• Difficulty speaking clearly
• Ringing in the ears
• Weakness on one side of the face or body

3. Headache (Migraine Attack)

This phase is characterized by head pain that may:

• Start mild, then progress into a throbbing pain
• Worsen with physical activity
• Affect one side of the head, shift sides, be located at the front, or spread across the whole head

Other symptoms may accompany the pain, such as:

• Fainting or dizziness
• Neck pain or stiffness
• Anxiety or depression
• Runny nose
• Sensitivity to light, noise, or odors
• Sleep disturbances

A migraine attack usually lasts around 4 hours, but in severe cases, it can persist for more than 3 days.

4. Postdrome (After-Headache Stage)

After the headache subsides, symptoms may linger for up to a day. About 80% of patients experience:

• Fatigue or exhaustion
• Unusual feelings of happiness or refreshment
• Muscle aches or weakness
• Food cravings or loss of appetite
• Trouble concentrating

Migraine Treatment

Several medications can help manage migraines. Some are general pain relievers, while others specifically target migraine-related pain pathways.

1. Analgesics and NSAIDs

Available over the counter, such as ibuprofen, naproxen, and aspirin. These can help relieve migraine pain but should be avoided in cases of aspirin allergy, asthma, kidney disease, or acid reflux. Daily overuse may lead to medication-overuse headaches.

2. Ergotamine and Ergot Alkaloids

Examples include dihydroergotamine, which act on migraine pathways. Side effects may include nausea, so they are often combined with anti-nausea medications.

3. Triptans

Specialized migraine drugs, available in several forms. They work best when taken early in the attack. Side effects may include tingling, drowsiness, or warmth.

4. CGRP Receptor Antagonists

These drugs target the calcitonin gene-related peptide (CGRP), a protein involved in migraine attacks. Useful for patients who cannot take triptans. Possible side effects include nausea, constipation, or fatigue.

5. Ditans

An example is lasmiditan, which works similarly to triptans but with a different mechanism. Side effects may include drowsiness or fatigue.

Migraine Medications Available in Pharmacies

The best migraine medicines include:

1. Adol 500 mg

Adol 500 mg is a general pain reliever and fever reducer, used for migraines among other conditions.

2. Brufen 400 mg

Brufen 400 mg is an NSAID that reduces inflammation and relieves pain, including migraine.

3. Nutraquinol 100 mg

Nutraquinol 100 mg contains ubiquinol (active form of CoQ10). A dietary supplement that may reduce migraine frequency and duration, with added benefits for fertility and physical performance.

4.Relpax 40 mg

Relpax 40 mg contains eletriptan, a triptan that narrows brain blood vessels and reduces migraine-inducing chemicals.

5. Imigran 50 mg

Imigran 50 mg contains sumatriptan, working with a similar mechanism as Relpax.

6. Nurtec 75 mg

Nurtec 75 mg contains rimegepant, a CGRP receptor antagonist. It helps relieve migraine symptoms and may reduce the number of attacks over time.

7. Topamax 25 mg

Topamax 25 mg is an anti-epileptic medication that can also prevent migraine attacks. Must be taken under medical supervision.

How to Protect Yourself from Migraine Attacks?

Here are some tips to help prevent migraine episodes:

• Use preventive medications such as certain anti-epileptics, antidepressants, or CGRP inhibitors.
• Take dietary supplements shown to reduce migraines, such as magnesium, vitamin B2, or CoQ10.
• Maintain a consistent sleep schedule, even on weekends.
• Exercise regularly but avoid overexertion.
• Eat meals on time and avoid skipping them.
• Manage stress with relaxation techniques such as walking or deep breathing.