- Migraine is an extremely debilitating collection of neurological symptoms with severe recurring intense throbbing pain on one side of the head, although in about 1/3 of attacks, both sides are affected.
- Attacks are often accompanied by one or more of the following: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face.
- In 15-20% of attacks, other neurological symptoms occur before the actual head pain.
- Attacks usually last between 4 and 72 hours.
- Migraine remains a poorly understood condition that is frequently undertreated.
Migraine affects nearly 1 in 4 U.S. households and the majority of migraine sufferers do not seek medical care for their pain. Nearly half of all migraine sufferers are never diagnosed. Even with the correct diagnosis, treating migraine can be very challenging. Combinations of various medications and other modalities are often the most effective therapy.
Fluctuations in estrogen levels can result in more severe and more frequent attacks. About 10-14% of American women have menstrual migraine; half of them have more than one attack each month, and 25% experience 4 or more severe attacks per month.
Management of migraine involves elimination of triggers. Migraine triggers include alteration of sleep-wake cycle; missing or delaying a meal; medications that cause dilation of the blood vessels in the head; medication overuse (which contributes to the progression from episodic migraine to chronic migraine); bright lights, sunlight, fluorescent lights, TV and movie viewing; certain foods; excessive noise; stress and/or underlying depression.
For optimal therapy, the following factors must be considered:
- Severity of the migraine
- Efficacy of the selected drug
- Side effects of each drug, and possible interactions with other medications or conditions
- Most appropriate route of administration (For example, oral meds would not be best for someone with symptoms of nausea and vomiting; sublingual and nasal preparations have a faster onset than oral meds.)
The goal of acute therapy is to stop or reduce the pain and other symptoms associated with the migraine while minimizing adverse effects and ultimately restoring the patient’s ability to function normally. Acute therapy should begin at the first sign or symptom of a migraine. If patients have frequent migraine attacks and do not respond consistently to acute therapy, then preventive medications should be taken to reduce migraine frequency and improve response to acute therapy. In addition to some medications, nutritional supplements such riboflavin, coenzyme Q10, cyanocobalamin, folic acid, and pyridoxine may help to prevent or improve migraine with minimal side effects.
Our compounding professionals will work together with patients and their health care providers to customize the most appropriate medication for each individual. Ask us for more information.