Pharmacy Times

Migraines: More Than an Annoyance

Author: Aimee Simone, Assistant Editor

June is Migraine and Headache Awareness Month, which makes it the perfect time to review the stages and treatments of this painful condition that affects some 36 million Americans.

Migraines are more than just intense headaches. They can be a disabling, chronic condition capable of increasing the risk of depression, sleep disorders, stroke, and heart attack. Thirty-six million Americans--approximately 12% of the population--experience migraines of some sort.
A migraine headache is typically characterized by throbbing or pulsing in one or multiple areas of the head and may be accompanied by nausea, vomiting, and heightened sensitivity to light and sounds. A migraine may last anywhere from 4 to 72 hours, and sufferers may experience headaches anywhere from a few times a year to more than once a week.
A migraine consists of up to 4 stages, although not all sufferers will experience all 4 stages with every migraine. The first stage, prodrome, occurs 1 or 2 days before a migraine’s onset. During this stage, sufferers may recognize subtle changes signaling the migraine’s approach, such as constipation, depression, food cravings, hyperactivity, neck stiffness, irritability, and uncontrollable yawning.
The second phase, called aura or an optical migraine, is experienced by approximately two-thirds of migraine sufferers and can occur immediately before or during an attack. Auras are symptoms of the nervous system that usually include visual disturbances, such as blurred vision, flashing lights, or zig-zag lines. These symptoms usually last between 20 and 60 minutes.
The third, or attack, phase is what is generally referred to as a migraine and consists of the headache and additional symptoms. In extreme cases, individuals experiencing the attack phase can feel lightheaded and may faint.
After the headache, individuals may experience the fourth phase, postdrome, in which they feel physically exhausted.
Although researchers are not exactly sure what causes migraines, there are known risk factors and triggers for the attacks. Family history is the most common risk factor for migraines, and approximately 90% of those with migraines have a family history of migraine attacks. In addition, women are 3 times more likely to have migraines than men.
The most common migraine triggers include hormonal changes in women, stress, exposure to bright lights or sun glare, changes in sleep patterns, changes in weather, intense physical activity, and consuming salty or processed foods, food additives, alcohol, highly caffeinated beverages, or certain medications.
People with migraines are often advised to keep a diary of their headaches in order to track their triggers and symptoms to help find a way to prevent and treat migraines in the future. Depending on the severity and frequency of attacks, migraines can be treated with either pain-relieving or preventive medications. Pain-reliving medications include both over-the-counter and prescription drugs that are taken during an attack to stop symptoms. Those who experience migraines more frequently are prescribed preventive medications that are taken regularly to help avoid or reduce the severity of attacks.
Although there is no cure for migraines, those who suffer from them can help mitigate the unpleasantness of the condition with help from their health care providers.