Migraines are a prevalent condition impacting more than 8.5 million individuals in the United Kingdom. They are characterised by a combination of symptoms, typically including an intense, pulsating headache located at the front or on one side of the head, heightened sensitivity to bright light and loud sounds as well as nausea and vomiting.
Around one in every five women experience migraines, in contrast to one in every fifteen men, with most individuals experiencing their first migraine before reaching the age of 40.
Causes
While scientific research has yet to pinpoint the exact cause of migraine headaches, they are believed to be triggered by temporary dilation of blood vessels in the brain. For some, migraines can be induced by factors such as stress, anxiety, sleep deprivation, shock, exhaustion or poor posture. Other common triggers include sensory overstimulation, certain medications and specific foods like alcohol and cheese. Occasionally, auras, which are warning signs such as visual disturbances like light flashes, zigzags, waves or stars, may precede a migraine.
Types
There are three distinct types of migraines:
- Migraine with aura: often referred to as classic migraines, these include warning signs of visual distortions.
- Migraine without aura: characterised by the absence of warning signs.
- Migraine with aura but no headache: in this case, only other symptoms like nausea are experienced.
While headaches typically manifest as a dull pain on both sides of the head and can persist for anywhere from 30 minutes to several days, migraines are characterised by more pronounced symptoms, including severe throbbing pain at the front or on one side of the head, vomiting and sensitivity to light. Migraines can last longer than tension headaches, often persisting for up to 72 hours.
Treatments
There are various treatment options available for migraines, ranging from over-the-counter painkillers like paracetamol and aspirin to more potent medications known as 5HT-receptor agonists, often referred to as triptans. While painkillers focus on alleviating the sensation of pain, triptan drugs target the root cause by constricting the temporarily swollen blood vessels in the brain. This approach not only relieves pain but also eliminates associated symptoms like nausea.
The choice of treatment depends on the severity and frequency of your migraines. Some individuals may find certain medicines more effective than others, and some can be taken with or without migraine auras. It is advisable to consult your GP if you are unsure about the best treatment for your condition.
At Gilbride Pharmacy, following a brief consultation with our pharmacist, we can provide the following non-prescription medications:
- Sumatriptan (Imigran)
- Zolmitriptan (Zomig)
- Rizatriptan (Maxalt)
Sumatriptan
Sumatriptan, also known as Imigran, is a treatment for migraine attacks, whether they occur with or without warning signs like visual disturbances, light flashes or waves.
How Does It Work? Sumatriptan contains the active ingredient sumatriptan succinate, which is a type of medication known as a triptan. Migraines are often linked to dilated blood vessels in the brain, and sumatriptan counteracts this by narrowing the blood vessels. This action provides relief from migraine symptoms, including pain, nausea, vomiting and sensitivity to light and sound.
How to Take It Sumatriptan tablets can be taken with or without food, swallowed whole with water. The sooner you take sumatriptan after your headache begins, the more effective it is. The typical adult dose is 50mg, but some individuals may require a higher dose of 100mg. Sumatriptan is not suitable for children or adolescents.
If the initial treatment is ineffective or if your headache recurs, you may take another capsule at least 2 hours after the first dose. However, do not take another dose of sumatriptan for the same attack. Remember that sumatriptan is intended for treating migraines, not preventing them.
How Quickly Does It Work? The relief from migraine symptoms typically peaks approximately 45 minutes after taking sumatriptan, with effects lasting for about 2 hours.
Who Should Use It? If you suffer from headaches that are unresponsive to common painkillers such as paracetamol, aspirin or ibuprofen, you can consider taking sumatriptan at a 50mg dose. Sumatriptan is recommended if you experience fewer than 10 migraine episodes each month.
Painkillers If the first dose of Sumatriptan proves ineffective, you can take a painkiller like paracetamol, aspirin or an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen.
Side Effects Sumatriptan, like all medications, may have side effects, although not everyone experiences them. Common side effects include:
- Dizziness
- Flushing
- Nausea
- Drowsiness
- Vomiting
It's worth noting that many of these symptoms could also be due to the migraine itself.
Zolmitriptan
Zolmitriptan, also known as Zomig, is a treatment for migraine headaches. Its active ingredient belongs to a class of medications known as triptans or serotonin 5-HT receptor agonists.
How Does It Work? Zolmitriptan works by reversing the temporary swelling of blood vessels around the brain, which is believed to be a cause of migraines, thereby relieving the headache associated with them.
How to Take It Zolmitriptan is available in tablet and dispersible tablet forms. For the best results, swallow a zolmitriptan tablet whole with water as soon as your migraine begins. The dispersible tablet should be placed on the tongue and allowed to dissolve.
The recommended dose of zolmitriptan is 2.5mg, which you can take with or without food as it does not affect the medication's effectiveness. You can take another tablet if your migraine recurs, but wait at least 2 hours after the initial dose. Do not exceed 2 tablets within 24 hours.
Note that zolmitriptan does not prevent migraine attacks.
How Quickly Does It Work? Zolmitriptan typically becomes significantly effective within 45 minutes to an hour after taking a tablet.
Side Effects Common side effects of zolmitriptan, affecting around 1 in 10 people, may include:
- Nausea
- Dry mouth
- Vomiting
- Dizziness
- Headache
Rizatriptan
Rizatriptan, also known as Maxalt, is a widely-used migraine treatment. Its active ingredient is rizatriptan benzoate, which belongs to the group of medications called triptans or selective serotonin 5-HT receptor agonists. Rizatriptan is effective at treating the headache phase of migraines, as it is thought that migraines are caused by temporarily widened blood vessels around the brain, and rizatriptan constricts these vessels to reverse the migraine's effects.
How to Take It The recommended dose of Rizatriptan is 10mg, to be swallowed with water as soon as a migraine begins. To ensure rapid absorption, take the medication on an empty stomach.
If your migraine recurs, you may take another tablet, but only after at least 2 hours have passed since the initial dose. Do not exceed 2 tablets in a 24-hour period, and remember that rizatriptan is not a preventative measure for migraines.
How Quickly Does It Work? Rizatriptan typically starts to alleviate migraine symptoms after about 30 minutes.
Duration The effects of the medication can last for 2-3 hours.
Side Effects Common side effects affecting up to 1 in 10 people may include:
- Dizziness
- Sleepiness
- Headache
- Dry mouth
- Stomach pains
- Throat discomfort
- Palpitations
- Decreased skin sensitivity
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