Eat wisely: (Consistent meals, don’t skip meals)
Identify triggers such as aged cheese, chocolate, excessive caffeine, alcohol.
Keep a food journal. This may help you find triggers that would otherwise be difficult to identify such as certain food colourings or additives. Until recently, avoiading migraine triggers was considered the best advice. But new research suggests this may actually increase sensitivity to potential triggers. A more useful approach may be to gradually expose yourself to triggers, and learn to cope with these headache triggers by using behavioral management techniques. These may include identifying and challenging negative thoughts, relaxation training, and stress reduction. More research is needed to understand if and how this approach is more effective in managing migraines.
Exercise regularly: See Pacing.
Reduce weight: Obesity is a know risk factor for migraines. See Weight Management.
Strive for balance: Sometimes you can’t get rid of headaches but making healthy lifestyle sources can help
These are some medications which your physician may prescribe:
Side effects listed are not an exhaustive list. They are generally the most important side effects that we consider when prescribing the drugs. You can click on the drug to get detailed information regarding side effects.
Topamax: Glaucoma, kidney stones, altered thinking, weight neutral, avoid in women considering pregnancy.
Amitriptyline: Weight gain and dry mouth.
Various blood pressure medications including propranolol, metoprolol, verapamil, candesartan : Possible dizziness, exercises intolerance, possible weight gain and diminished mood.
Valproate: Nausea, somnolence, weight gain, and rarely tremors. Must be avoided in patients who are considering or are at risk of getting pregnant. Rarely associated with blood abnormalities.
Botox: This is given every 3 months: eyelid drooping, rarely urinary retention or UTI’s, rarely flu like symptoms. Occasional headache following treatment.
Aimovig, Emgality or Ajovy: These are newer drugs that are administered as an injection once per month. The are in a new class of drugs which involve a molecule called CGRP. The most common complaint is injection site pain/reaction. Some people may experience constipation. Ajovy also comes in a dose which can be administered every 3 months.
Qulipta and Ubrelvy also work on the CGRP system but they are taken orally. The advantage is that you do not need to inject yourself but there are higher rates of drug interactions. Qulipta, which is preventative drug must be taken on a daily basis. It has a short half life so as soon as you stop taking the medication, the drug clears pretty quickly. This is different from the injectables that may linger in the body for months. Side effects include nausea, drowsiness, tiredness, or constipation.
Ubrelvy is taken as an abortive medication and is a good alternative to triptans. Its main side effect is nausea and dry mouth.