Avoid these common pitfalls for a more successful treatment regimen.
Perfecting your migraine treatment regimen may take some time. Everyone who gets migraines may struggle with a unique set of triggers or react differently to medicines. Learning the common pitfalls of migraine treatment might help you find your personal treatment regimen faster.
DON’T take acute migraine treatment more than 10 days a month.
Acute migraine treatment refers to medicines that help stop or lessen the severity of a migraine that has already started. For example, triptans and ergots are acute migraine treatments.
However, if you find yourself needing these medicines more than two or three times a week, you should talk to your doctor about other options. “Acute migraine medications, when taken too frequently, can cause something called medication overuse headache,” says Sylvia Mohen, MD, neurologist in New York City.
“The issue with medication overuse is it can actually make your overall migraines worse. You can go from having a few migraines a month to having 15-plus migraines a month just by overusing your acute treatment,” says Dr. Mohen. This can even include frequent NSAID use.
DO keep a consistent sleep schedule.
“Sleep deprivation is a major migraine trigger for a number of people. Sometimes even underlying sleep disturbances can be contributing to your migraine, like underlying sleep apnea,” says Dr. Mohen.
Sleep deprivation is a common problem to watch out for, but it’s also important to know that sleeping too long can also trigger migraines in some people.
DON’T ignore early migraine symptoms.
“It’s important to not ignore early warning signs of a migraine because it may progress into a more severe intractable migraine,” says Dr. Mohen. Taking your acute migraine treatment as soon as warning signs appear can help lessen the severity of a migraine. In some cases, it may even prevent it entirely.
DO talk to your doctor if your treatment isn’t working.
It’s important to keep in mind that there are many treatment options available for migraines. That means you don’t have to settle for an option that’s not meeting your expectations.
Additionally, your doctor can help you catch any challenges that might be affecting your treatment success. “Are you taking it routinely every day? Is it causing side effects? Are you just still having a lot of migraines despite taking the medication?” says Dr. Mohen. “There may be different ways to intervene depending on what’s going on.”
A migraine-friendly lifestyle can also help your treatment success. This includes eating regularly, staying hydrated, exercising, limiting screen time, and following a consistent sleep schedule, according to Dr. Mohen. Learn more lifestyle tips for treating migraines here.
Sylvia Mohen, MD, is a neurologist at New York Neurology Associates, P.C.
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If you don't really see a dramatic improvement
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then it is actually,
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it's a good point to really sit back and look at how effective
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you feel the treatment is.
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There are a number of ways people can learn
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to predict their migraine attacks early.
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Sometimes you can have very well-defined,
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like for women, the menstrual cycle can be a big trigger,
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so for a number of female patients,
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you may realize that the day or two
before your period
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is when you're going to have the migraines,
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and there are mentrual migraine-specifc treatments
for that reason.
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You may recognize certain environmental triggers
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like weather changes are often a very frequent trigger.
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For some patients, alcohol can be a big trigger.
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Lack of caffeine, travel, sleep deprivation.
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Minimizing these triggers can be important,
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but sometimes knowing that you're going to be
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in a situation that's going to provoke a headache
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can give you a heads-up that maybe it's time
to do something
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or take something to turn the headache off
as soon as it starts.
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It's important to not ignore early warning signs of a migraine
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because it may progress
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into a more severe intractable migraine.
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There are sometimes conditions where people will go
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into migraines that don't really respond to the treatments
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they take to treat the acute migraines,
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and that's why it's important to treat early.
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Sometimes you can get really stuck
in these headache cycles
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and they can go on for a while,
in which case you may need
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something stronger to break them.
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Overall, headache hygiene is very important
in preventing migraines
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for people who are susceptible to them.
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Routine sleep is very important,
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eating regularly throughout the day is very important.
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Hypoglycemia, or low blood sugar,
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can be a significant trigger for a lot of people.
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Dehydration is a big trigger for a lot of people
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so it's important to make sure you're hydrating.
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Exercise can be very important in controlling
migraines as well,
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and limiting screen time.
Screens can be a provoking factor
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for some people as well.
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Acute migraine medications, when taken too frequently,
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can cause something called medication overuse headache.
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All acute treatments have some degree of risk
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for causing medication overuse.
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Certain medications carry higher risk than others.
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Particularly opioids and barbiturates
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seem to be very higher risk for medication overuse,
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and the issue with medication overuse is it can actually
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make your overall migraines worse.
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You can go from having a few migraines a month
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to having 15-plus migraines a month
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just by overusing your acute treatment.
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The general rule of thumb is you should not be taking
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an acute treatment more than two to three times a week.
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If your treatment's really not working,
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you should come in and see your doctor
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and try to give them a good picture of why it's not working.
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Are you taking it routinely every day?
Is it causing side effects?
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Are you just still having a lot of migraines
despite taking the medication?
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There may be different ways to intervene depending on
what's going on.
- Acute treatment of migraine in adults. Waltham, MA: UpToDate, 2020. (Accessed on August 3, 2020)
- Photosensitivity and the headache and migraine patient. American Migraine Foundation, 2015. (Accessed on August 3, 2020)
- Preventive treatment of migraine in adults. Waltham, MA: UpToDate, 2020. (Accessed on August 3, 2020)
- Top 10 migraine triggers and how to deal with them. American Migraine Foundation, 2017. (Accessed on August 3, 2020)
- What to do when migraine treatment fails. Mount Royal, NJ: American Headache Society. (Accessed on August 3, 2020)