Migraine

The underlying causes of migraines are unknown. However, they are believed to be related to a mix of environmental and genetic factors. They run in families in about two-thirds of cases and rarely occur due to a single gene defect. While migraines were once believed to be more common in those of high intelligence, this now does not appear to be true. A number of psychological conditions are associated, including depression, anxiety, and bipolar disorder, as are many biological events or triggers.

Other factors that may trigger a migraine include:

• bright lights
• severe heat, or other extremes in weather
• dehydration
• changes in barometric pressure
• hormone changes in women, such as estrogen/progesterone fluctuations during menstruation, pregnancy, or menopause
• stress
• loud sounds
• intense physical activity
• use of certain medications, such as oral contraceptives or nitroglycerin
• smoking
• alcohol use

A migraine is usually a moderate to severe headache, felt as a throbbing pain on one side of the head. Many people also have symptoms such as feeling sick, being sick and increased sensitivity to light or sound.

About 15–30% of people with migraines experience them with an aura  – where there are specific warning signs just before the migraine begins, such as seeing flashing lights. But the majority will happen without any specific warning signs. 

The severity of the pain, duration of the headache, and frequency of attacks are variable. A migraine lasting longer than 72 hours is termed status migrainosus. There are four possible phases to a migraine, although not all the phases are necessarily experienced:

• The prodrome, which occurs hours or days before the headache
• The aura, which immediately precedes the headache
• The pain phase, also known as headache phase
• The postdrome, the effects experienced following the end of a migraine attack

Migraine in children

Children may also have migraines, but this is less common than in adults. The symptoms are the same as in adults, but children’s attacks are often shorter. In half of children with migraines, it disappears when the child is about 15 years old.

There are various factors that can trigger migraines – called triggers. Common triggers are hormone changes, some foods – such as chocolate, strong cheeses and red wines – strong smells, insomnia and weather changes. You can try to prevent and relieve your migraines by:

• relaxation exercises
• exercise
• eating regularly.

If you are taking birth control pills and feel they make your migraines worse, you should switch to an alternative form of contraception. 

Talk to a doctor for advice. If you have migraines with aura, you should not use combined oral contraceptives.

If you have a migraine attack you should try to sleep – the attack will disappear faster during sleep or rest in a dark room.

If you have been diagnosed with migraine, there are various drugs that can help. There are preventative drugs that reduce the risk of having a migraine attack and medicines that relieve an attack.

Analgesics
Recommended initial treatment for those with mild to moderate symptoms are simple analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or the combination of paracetamol (also known as acetaminophen) and aspirin.

Triptans
Triptans such as sumatriptan are effective for both pain and nausea in up to 75% of people. When sumatriptan is taken with naproxen it works better. Triptans are the initially recommended treatments for those with moderate to severe pain or those with milder symptoms who do not respond to simple analgesics.

CBT
Cognitive behavioral therapy has good results as a treatment method for migraine.

If you have recurring, severe headaches, you should get medical advice.

APPOTEK can help you with migraines as follows:

• consulting
• individual assessment and prescriptions if needed
• psychological treatment.