Treatment options for migraine patients

From the NYTimes:

"Migraines are notoriously tricky to treat. Those who suffer from these disabling headaches often try a dozen or so medications before they find something that works.

“What might be a miracle drug for one person could be a dud for another.” Be prepared for a multi-tiered approach.

Doctors typically prescribe a triptan drug or an ergot-related drug to help people control infrequent migraine attacks. There are 7 types of triptans. The best-seller Imitrex (sumatriptan) is available in an affordable generic version (the chemical formula is shown above). Triptans are far more popular, but many people who do not respond well to triptans do well with the ergots, such as D.H.E. (dihydroergotamine), Dr. Saper said.

If you have migraines at least weekly your doctor may prescribe a preventative medicine. “Prescription preventatives are grossly underutilized. They can be extremely effective for some people.”

Preventive medicines, taken every day, include antiseizure drugs, beta blockers and tricyclic antidepressants."

References:
Migraines Force Sufferers to Do Their Homework
http://www.nytimes.com/2010/01/30/health/30patient.html
NYTimes, Patient Voices: Migraine
http://www.nytimes.com/interactive/2009/12/15/health/healthguide/TE_migraine.html
Image source: Sumatriptan, Wikipedia, public domain.

Related:
Migraine with aura is an independent risk factor for cardiovascular and all cause mortality in men and women http://goo.gl/kAxc
Migraine with aura might, in addition to ischaemic events, also be a risk factor for haemorrhagic stroke http://goo.gl/GQvf
Review: Which drugs are effective for preventing migraine headache? http://goo.gl/WXfEl
Migraine headaches are more common in patients with allergic rhinitis - immunotherapy decreases headache frequency http://goo.gl/XEIBq
Pharmacological prevention of migraine - BMJ review http://goo.gl/Q5K2m

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