Written By: Abier Hamami. RPH. CPHQ

What is a Migraine Headache?


Migraine is a moderate to severe headache, throbbing or pulsing, one-sided, worsened


by activity, and may be accompanied by nausea, vomiting, and photophobia.


Is Migraine limited to a certain age group or gender?


Migraine can affect people at any age, but it is most common from 25 to 55 years of age. Migraine prevalence also varies with gender; it is two to three times more common in women than in men.


What causes a migraine attack?


The cause of migraine is not yet clear, but certain factors ‘trigger’ their attacks. These may include too much or too little sleep, strong light, weather changes and specific foods.

In women, hormonal changes at certain times of life or at the onset of menstruation can trigger migraines.


Theories state that a migraine is caused when a physiological trigger, or triggers, cause vasodilation (expansion of the blood vessels) in the cranial blood vessels, which activates trigeminal nerve endings in the brain.


What are the symptoms of a migraine attack?


Migraine attacks usually involve auras, which are symptoms originating from the brain and usually occur about 20 minutes to one hour before the headache attack. The symptoms include problems with vision, hearing or speech, disorientation or confusion and ‘pins and needles’ feelings in certain parts of the body. The aura may disappear before the headache begins or may last into the headache phase.


The headache is usually throbbing, painful, and typically occurs on one side of the head. Many people also experience nausea and some actually vomit during a migraine attack. Other symptoms that often accompany migraines include sensitivity to light, sound and smells.


What should you know about medications for acute migraine attacks?


Most migraine medications are designed to constrict the size of your blood vessels, you must be alert to changes in your blood flow.

Listed below are the most common acute medications for migraine you should always consult your physician to ensure that you receive the most appropriate treatment for your migraine.


Simple analgesics

Analgesics reduce the perception of pain by raising the pain threshold. They do not alter the cause of the pain, but simply mask the feeling of pain. Simple analgesics, such as paracetamol (acetaminophen), can be effective in patients with mild-to-moderate and infrequent migraines.

Combination analgesics

Caffeine and codeine, for example, are often combined with simple analgesics and/or NSAIDs

Non Steroidal Anti Inflammatory Drugs NSAIDs:

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or Diclofenac are also often prescribed for the acute treatment of mild-to-moderate migraine attacks.

Triptans (selective Serotonin 5-HT agonists):

 Naratriptan, Rizatriptan, Sumatriptan, Almotriptan, Frovatriptan, Zolmitriptan, and Eletriptan are prescription medications designed specifically for the treatment of acute migraine.

They act to inhibit vasodilation and inflammation of intracranial, and extracerebral blood vessels.

They can be associated with adverse effects, including parasthesias, flushing, chest pain or tightness, dizziness, drowsiness, or nausea/vomiting.

Ergotamine and ergot derivatives:

Ergotamine exerts its action by constricting blood vessels. Ergotamine and its derivative, dihydroergotamine, are sometimes used to treat moderate-to-severe migraine.

It can be associated with nausea/vomiting, mild weakness and numbness of extremities

How can you prevent Migraine Headache?


You can start preventive treatment if:


Acute therapy alone has failed to control the symptoms.

You experience three or more attacks per month.

Your migraines are predictable.

Some of the more common types of medication used for preventive migraine treatment include antidepressants (Amitriptyline), anticonvulsants(sodium Valproate), beta-blockers(Propranolol), calcium channel blockers (Flunarizine).


What are the behavioral changes that may help to reduce migraine attacks?


The behavioral changes that may help to reduce the frequency of attacks are:


Regular sleep

Regular exercise

Regular meals

Avoid foods that you think may trigger your attacks(Cheese, Chocolate, monosodium glutamate)

Avoid excessive use of over-the-counter pain-killing medications

Avoid stress

Limit caffeine intake

Avoid alcohol






The Migraine Disability Information Center



Drug Topics: The Online Newsmagazine for Pharmacists