Medical Treatments for Headache & Migraine
Medical treatments for headaches and migraines often begin with over-the-counter or prescribed medications, including NSAIDs, paracetamol, triptans, ergotamine, and anti-emetics. Combination medicines, containing both painkillers and anti-sickness medications, can also be effective, especially when combined with a triptan.
Prophylactic treatments for migraines may include medications like topiramate, candesartan, propranolol, gabapentin, riboflavin B2, and amitriptyline. Special consideration is needed for women of childbearing age due to potential risks associated with certain medications.
Cluster headaches are typically treated with oxygen, while prophylactic treatment options may include verapamil or transcranial magnetic stimulation (TMS).
Botulinum toxin type A (BOTOX) injections and monoclonal antibodies, such as fremanezumab, galcenezumab, and erenumab, are recommended for chronic migraine sufferers who have not responded to previous treatments. Erenumab, a self-administered injection, is a newer option for migraine prevention.
Additionally, targeting the calcitonin gene-related peptide (CGRP) pathway has revolutionized migraine management. CGRP inhibitors, including monoclonal antibodies and CGRP receptor antagonists like Rimegepant, have shown promising results in preventing and treating migraines.
With advancements in migraine-specific therapies, including CGRP inhibitors, the treatment paradigm for migraines is evolving, offering new possibilities for migraine prevention and relief.