Selective serotonin reuptake inhibitors
Antidepressants such as fluoxetine (Prozac® and others) have fewer side effects than tricyclic antidepressants, but are generally not considered effective for tension headache.Anticonvulsants and muscle relaxants
Other medications that can prevent tension headache include anticonvulsants, such as topiramate (Topamax®), gabapentin (Neurontin®), and muscle relaxants such as thiocolchicoside (Adalgur).
Preventive medications can start to be effective after several weeks, because they must accumulate in the nervous system. People should not be discouraged if they do not notice an immediate improvement as it may take a couple of months or more.
It must be remembered that excessive use of caffeine or analgesics to relieve pain in the acute phase can reduce the effect of a preventive medication.
In order to obtain the greatest effectiveness of a preventive medicine, it is necessary to take the minimum possible quantity of anti-inflammatories.
The doctor monitors the evolution of the treatment to make sure that the preventive medicine is working. If the headache is under control, the dose of the medication can be gradually reduced.

 

Medications for migraine

Several medications have been developed for the treatment of migraine.
In addition, some medications often used to treat other diseases can also be effective in relieving or preventing migraine.

The medications used to combat migraine fall into two categories:

Analgesic medications
These are used during an acute migraine attack and have been developed to relieve symptoms that are already present.Preventive medications
Generally, these types of medications are used daily to reduce the severity or frequency of the migraine. To begin a preventive treatment of migraine, the frequency and severity of the headache, the degree of disability caused by headache and other concomitant diseases must be taken into account. Some medications are not recommended for pregnant or breastfeeding women and are not recommended for children either. The doctor can help find the most suitable medication for each person.

Analgesic drugs
For better results, you must take analgesic drugs as soon as the signs and symptoms of migraine appear. It may be beneficial to lie down to sleep in a dark room after taking medications.

Analgesics
These medications, such as ibuprofen (Ibudol and Espididol, etc.), or paracetamol (Efferalgan, etc.) can help relieve mild migraine.
Medications that are marketed as specific for migraine, such as the combination of paracetamol, aspirin and caffeine (Saldeva and others), can relieve moderate pain caused by migraine, but are not effective in relieving severe migraines. If taken too often or for too long, these medications can cause ulcers, gastrointestinal bleeding and rebound pain.

Triptans
For many people who suffer from migraine attacks, triptans are the most commonly used medication. These medications are effective in relieving pain, nausea, sensitivity to light (photophobia) and noise, these are all symptoms of migraine.
Among the most prescribed medications is sumatriptan (Imigran®).
The side effects of the triptans include: nausea, vertigo and muscle weakness. These medications are not recommended for people at risk of heart attack and stroke.

Ergotamine
It is a medicine that is the combination between ergotamine and caffeine (Cafergot®), its price is lower, but it is less effective compared to the triptans. The effectiveness of this medication is greater in patients in whom the pain lasts 48 hours.

Anti-nausea medications
Often, migraine is accompanied by nausea and, sometimes, vomiting. For this reason, a medicine for nausea is recommended, which is usually combined with other medications.
Among the medications that are most prescribed is metoclopramide (Primperan).

Opiates
Drugs containing narcotic substances, especially codeine, can be used for the treatment of pain caused by migraine in cases where people can not take the triptans or ergotamine. Narcotics cause dependence and are generally taken as a last resort.

Dexamethasone (for example Dexa-tavegil)
This corticosteroid can be used in combination with other medications to reduce pain. Dexamethasone should not be used regularly due to the risk of steroid toxicity.

 

Preventive medications

People who suffer two or more debilitating attacks per month can undergo preventive treatment, if the headache is resistant to analgesic drugs or if the signs and symptoms of migraine include a persistent aura, numbness or weakness.
Preventive medications can reduce the frequency, severity, and duration of the headache and may increase the effectiveness of medications to relieve symptoms. The doctor may recommend taking preventive medications daily, only when a predictable factor approaches, such as example, menstruation.
In most cases, preventive medications do not completely eliminate the headache and some serious side effects.
If the patient has had good results with preventive medications, that is, if for a period of time ranging from 6 months to a year he has not had a migraine again, the doctor may recommend that he stop the medications to see if the migraine returns To appear.
To obtain better results, you must use the medications listed below following the doctor’s instructions:

Cardiovascular drugs
Beta blockers are often used to treat high blood pressure in the coronary artery, but they can also reduce the frequency and severity of migraine. It has been demonstrated that propranolol (Sumial®) is a very effective beta-blocker for the prevention of migraine.
In addition, antihypertensive medications (to reduce blood pressure) such as lisinopril (Zestril) are effective in reducing the duration and severity of migraine.
Scientists still do not understand exactly why these cardiovascular drugs prevent migraine attacks. Some of the side effects include: dizziness, drowsiness or vertigo.

Antidepressants
Some antidepressants help prevent certain types of headaches, including migraine. Often, tricyclic antidepressants, such as amitriptyline (Tryptisol) are prescribed for the prevention of migraine.
Tricyclic antidepressants can prevent migraine because its action influences serotonin and other brain chemicals.
It has been shown that only amitriptyline is effective for migraine. People should not be depressed to get the benefits of these medications.
Among the different types of antidepressants are the selective serotonin reuptake inhibitors, but studies show that good results have not been obtained with regard to the prevention of migraine.

Antiepileptic
medications Some antiepileptic drugs, such as sodium valproate (Depakine), topiramate (Topamax), and gabapentin, reduce the frequency with which migraine occurs.
Be careful because too high doses of these antiepileptic drugs can cause side effects such as nausea, diarrhea, vomiting, cramps, hair loss and vertigo.

Cyproheptadine
It is an antihistamine that alters the activity of serotonin. Doctors prescribe it for children as a preventive measure.

Botulinum toxin type A (Botox)
The Food and Drug Administration has approved botulinum toxin type A for the treatment of migraine in adults. Injections are placed in the muscles of the forehead and neck. When the injection is effective, the treatment should be repeated usually every 12 weeks.