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Migraine Prevention: Treatment, Procedure, Cost and Side Effects

Last Updated: Oct 30, 2024

What is the treatment?

Migraine prevention therapy is performed to decrease the frequency of recurring migraines, their severity and length; this, in turn, increases the effectiveness of pain-relieving medications. Certain patients suffer from serious aura in migraine. Aura may include blind spots and zigzag lines across the field of vision, temporary vision loss, flashes of light etc. In such cases, prevention therapy is a must. The most common medications for migraine prevention are – cardiovascular drugs, anti-depressants, anti-seizure drugs, Botox. If one is not comfortable with the idea of medication, there are certain self-care measures as well that can help in preventing migraine to a certain extent. Muscle relaxation exercises, consistent sleep patterns can go a long way in reducing the frequency of severe migraine attacks. If one can feel a migraine headache coming on, placing an ice pack on the back of the neck and resting in a dark, quiet room will help soothe the attack a bit.

How is the treatment done?

Beta blockers, that are used to treat high blood pressure and coronary artery diseases, are one of the most common medications prescribed for the treatment of frequent and severe migraines. Beta blockers such as propranolol, metoprolol tartrate and timolol have been proven successful in the treatment of migraine. Anti-depressants have had proven results in treating migraines even in people without depression. These anti-depressants reduce the frequency of migraines by affecting the serotonin levels and also the levels of other chemicals present in the human brain. Anti-seizure medication, such as valproate (Depacon) and topiramate (Topamax), have successfully reduced the frequency of migraines in the past. OnabotulinumtoxinA, more commonly known as Botox, has also proved its worth in the treatment of chronic migraines in adults. In the treatment involving Botox, it is injected into the muscles of the forehead and neck for it to be effective. The botox treatment is not a one-time solution. It has to be repeated every 12 weeks in order to notice substantial improvement. Patients, who respond well to the botox injections, can also opt for the nerve decompression surgery.

Who is eligible for the treatment? (When is the treatment done?)

If a person has more than 4 exhausting migraine attacks per month and each attack lasts for more than 12 hours, he/she is a perfect candidate for the migraine preventive therapy. People in need of the preventive therapy can experience a prolonged aura or weakness and pain-relieving medications fail to work for them.

Who is not eligible for the treatment?

Cardiovascular drugs are widely used during migraine prevention therapy. So, if the patient is over 60, uses tobacco, or has certain heart conditions, he/she must consult the doctor for some alternate medication.

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Are there any side effects?

Preventive medication do not always stop the headaches completely and the medications usually prescribed for migraine prevention can bring about a lot of side-effects. Some of the anti-depressants used for the prevention therapy can cause sleepiness, dry mouth, constipation, weight gain and other side effects. Topiramate is a common anti-seizure drug used to treat migraines. Topiramate may cause diarrhoea, nausea, weight loss, memory difficulties and concentration problems.

What are the post-treatment guidelines?

It is recommended to lead a relatively stress-free lifestyle as stress is one of the most common factors that can trigger a migraine attack. Also, a regular sleep cycle consisting of an adequate amount of sleep is very crucial for people who have a history of migraines.

How long does it take to recover?

Migraine prevention does not always ensure complete freedom from the ailment; it is more targeted towards reducing the frequency and severity of the attacks. A person suffering from a migraine attack can take from 4 hours to almost 72 hours, in the worst possible cases, to recover.

What is the price of the treatment in India?

The cost of the treatment varies depending on the the particular form of treatment the patient opts for. The traditional medications don't cost much; the newly introduced botox treatment costs around Rs.19,200-Rs.38,400.

Are the results of the treatment permanent?

Migraine is often a chronic condition in adults. Prevention therapy can reduce the frequency, severity and longevity of the attacks, but the headaches do not seize to happen completely.

What are the alternatives to the treatment?

If one suffers chronic migraine pains and is not comfortable with medications, he/she can opt for several unconventional ways to fight the headaches. Acupuncture is one such option. It has been seen that this treatment, in which a practitioner inserts many thin, disposable needles into several areas of the skin at defined points, has had positive results in the treatment of migraines. Biofeedback, message therapy, cognitive behavioral therapy are some other non-traditional ways to treat migraines. Although studies have shown mixed results, there is some evidence of herbs like feverfew and butterbur somewhat reducing the severity of migraines.

References

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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurology
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