Migraine

Although migraine most often strikes women aged 18 to 50, it can affect men and women of any age. Learn about the difference between regular and migraine headaches, what causes  migraine, and how to treat it.

What is migraine?

Migraine is the third most common illness in the world and is often passed down from parents to children. Its cause is complex, as the condition involves several areas of the brain along with the brain’s chemical, electrical and inflammation responses.

Migraine is a type of headache that comes on as an attack. These episodes can last from 2 to 72 hours, and the frequency varies from person to person. Here are a few signs and symptoms that separate migraine headaches from ordinary ones:

• intense pain that often starts on one  side of the head
• pulsing or throbbing pain
• neck pain
• nausea and vomiting
• hypersensitivity to noise, light and smells
• increased pain during physical activity, such as simply going up or down the stairs

Approximately 30% of people with migraine have ocular migraine, which is also called migraine with aura. An aura, which lasts 5 minutes to less than 1 hour, can precede the migraine. You may see flashes of light, get numbness and tingling in your hands, or gradually and temporarily lose sight in one or both eyes. During the aura phase, you should take medication to stop the episode as quickly as possible. Once it sets in, a migraine attack is much more difficult to treat.

When to consult a doctor

Migraines can sometimes hide another more serious illness. If your migraine lasts more than 3 days, it is strongly recommended that you seek emergency medical help.

You should also see a doctor in the case of:

• intense and sudden headache
• increase in headache frequency and intensity
• headache with fever
• headache with paralysis in the face or body
• lack of relief from pain medication or increased doses of pain medication

What triggers a migraine?

It’s important that you learn to recognize the factors that can trigger your migraines. These triggers are different for everyone. The most common are:

• A lack of sleep, jet lag or an irregular sleep cycle (e.g., from night shift work).
• Stress or a sudden drop in stress (e.g., the start of a vacation).
• Hormonal changes (ovulation, menstrual period, the first trimester of pregnancy, premenopause).
• Strong odours (perfumes, cigarette smoke).
• Alcohol.
• Foods such as garlic, chocolate, deli meats, aged cheeses, red wine and foods that contain monosodium glutamate (check food labels).
• Caffeine withdrawal.
• Certain medications (talk to your pharmacist).
• Excessive use of painkillers.

Migraine diary

If you suffer from migraines, you should keep the following notes in a diary:

• frequency and duration of your migraines
•  your migraine symptoms
• your migraine trigger(s)
• medications that relieve your pain and how often you take them
• the impact of your migraines on your daily activities (days off work, inability to drive, etc.)

Over time, you will recognize the triggers to avoid. When you talk to your pharmacist or doctor, you’ll also have a better idea of what causes your migraines and how severe they are.

Migraine treatment

Mild to moderate migraines

Over-the-counter (OTC) analgesics (acetaminophen, ibuprofen, acetylsalicylic acid) are effective at alleviating mild to moderate migraines, if you take them as soon as the first symptoms appear and at the recommended doses. Watch out!

You shouldn’t take acetylsalicylic acid or ibuprofen if you have a stomach ulcer or a sensitive stomach or if you are in the first or third trimester of pregnancy. These products may interact with certain drugs or have an impact on certain health conditions. Talk to your pharmacist.

Your doctor can also prescribe other anti-inflammatory drugs or painkillers if OTC analgesics are ineffective or insufficient.

Severe migraines

To treat this type of migraine headache, you will often need migraine medication prescribed by a doctor. You usually need to take this medication at the start of your migraine or aura (if you get them) so that you can treat the attack before the migraine sets in. Triptans are a class of drugs often used to treat this migraine stage.

If you get more than 3 migraines a month, if migraine greatly affects your quality of life, or if you get “rebound” migraines from taking too much medication, your doctor may prescribe a preventive medication. You will need to take this prescription regularly every day to prevent migraine or reduce the number of attacks.

Can medication cause headaches?

Taking too many analgesics over a long period can lead to a vicious circle of rebound migraines or medication headaches. This problem can happen when you take too many OTC drugs such as acetaminophen, ibuprofen, or acetylsalicylic acid, and it can also occur with codeine and prescription drugs.

You need to pay close attention to how many analgesics you take, as over time, they may become the cause of your headaches or migraines. If you think this may be happening to you, talk to your pharmacist or doctor, who will help you gradually decrease your use of painkillers and break the cycle of rebound migraines.

Other migraine treatments

In general, people who suffer from migraines should decrease their level of stress and learn how to better manage it. Relaxation exercises can be useful for preventing migraines in some people.

When a migraine comes on, you should lie down in a cool, dark place away from noise. Place a cold towel or ice pack wrapped in a cloth on your forehead to alleviate the pain.

Some natural health products, such as magnesium, coenzyme Q10, butterbur and vitamin B2 have also been studied for their migraine prevention properties. Talk to your pharmacist to find out if these products are right for you.

If you want more information about migraine, don’t hesitate to talk to your pharmacist.