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Medical Intervention for Migraine

While the medical community has a number of theories as to the origin of migraine (the most common hypothesis is a disorder of the serotonergic control system), the cause is still unknown. This is clearly indicated in the treatment of the disorder, which consists of a scattered assortment of drugs, the majority of which were not expressly designed to treat migraine in the first place.

Traditionally, neurologists prescribe two types of medications for migraine: preventive and pain relieving. It is safe to assume that many medical preventive options are ineffective, as pain relieving drugs are still a necessity for many migraineurs.

Preventive medications include cardiovascular drugs (beta blockers most commonly used for high blood pressure), antidepressants, anti-seizure drugs, antihistamines, and—in some extreme cases—botulinum toxin type A (Botox).

Pain medications for migraine include non-steroidal anti-inflammatory drugs (NSAIDs), triptans, anti-nausea drugs, butalbital combinations (a sedative combined with aspirin, acetaminophen, or caffeine), and opiates. Of these, at least three options (NSAIDs, opiates, and butalbital) may cause rebound headaches, a phenomenon in which the drug that brings relief may actually cause another headache. NSAIDs, if taken for too long and in high enough doses, may cause ulcers or gastrointestinal bleeding. Opiates are known for having addictive properties.