What Do You Do When Migraine Meds Don't Work?

Oct 17, 2010 Migraine

A migraine is a neurological condition that is debilitating and often results in absence from work.  Some people can control the pain using over the counter medication such as Ibuprofen while others have to rely on prescription drugs.  

Triptans are used to treat the symptoms of a migraine.  They are serotonin 5 HT1B 1D receptor agonists which stop pain reaching its full intensity.   Sumatriptan, Zolmitriptan, Rizatriptan, Imigran, Maxalt Melt and Zomig are well-known migraine treatments.

Some people respond to different treatments better than others so you may have to try different ones until you find the right one for you.  It is important that you take the correct dose at the right time so they are most effective.


Different Types Of Migraine

There are three main types of migraine; aura without pain, aura with pain and headache without aura.  

Most attacks are preceded by the following symptoms; visual problems, numbness, feeling dizzy, difficulty speaking and rarely loss of consciousness. The aura is generally a warning sign of an imminent migraine although some people don’t get warnings and can suddenly feel ill.

Headaches normally affect one side of the head and can vary in intensity. However some people can have pain on both sides of the head or their face and neck can be affected.  It is possible to have a migraine without having a headache at all.  

Other possible symptoms include; nausea, vomiting, light sensitivity, sweating, poor concentration, feeling extremes of temperature, stomach ache and diarrhoea. It is uncertain what causes migraines to occur but it is suspected that it is due to changes in brain activity.

There is also possibly a genetic link as the condition can run in families.  Sufferers are encouraged to record triggers so that lifestyle changes can be made to reduce attacks.(Source: NHS).


How Triptans Work

Although there is no definitive treatment for migraines, triptans are painkillers that have been devised to specifically ease symptoms.  They work by causing blood vessels to contract and ultimately reversing the causes of migraines.  

As with all medication, there are side effects including; tightness, tingling and flushing.  An anti-sickness medication will also be prescribed at the same time.   People find some triptans more effective than others so finding the right one may involve trying different medications.  

This type of medication is most effective when taken during the early onset of a migraine as they can prevent a full attack.  It is important that you don’t exceed your dose otherwise you will suffer from a medication overuse headache.  

Overuse of painkillers can lead to addiction which can result in long-term complications. Occasionally triptans are ineffective in the treatment of migraines so alternative ways of dealing with the discomfort are necessary.


What To Do If Meds Don’t Work

Your doctor may refer you to a specialist migraine clinic where Transcranial Magnetic stimulation can be tried to ease symptoms.  The treatment involves passing magnetic pulses through the skin.  

It is unclear why it works but it is effective for some people but not everyone.  Acupuncture is also advised as it has proved effective for some people. Sadly some people don’t respond to treatment and continue to suffer migraines.  

It is therefore important that you record triggers and times that you are most likely to suffer an attack. Migraine forecasts are being used as a tool to help people gain a full understanding of the pattern of attacks.  

It does involve recording every aspect of your life for over a period of time to gain a full picture of what your triggers may be.   Underlying health conditions can also cause severe headaches so you may want to get yourself checked out by your doctor.  

The cause of your headache may not be a migraine and the condition can be treated resulting in a reduction in headaches.   If you are not having any success with your present doctor then you may want to consider seeking a second opinion.  Different doctors have different approaches to treating conditions so someone new may suggest treatment that will work for you.


By Parv Sagoo (December 2017)


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