What they are and how they work

Migraine is a neurological condition that results in recurring headaches characterized by severe throbbing or throbbing pain. According to the National Institute of Neurological Disorders and Stroke, approximately 12% of people in the United States suffer from migraine.

There are two types of migraine treatment: abortive and preventive. Abortion treatments work to stop a migraine attack when it occurs, while preventative treatments aim to prevent additional migraine attacks.

There are several types of drugs that are used as an abortion treatment for migraine. Read on to find out what they are, how they work and more.

Migraine abortion medications are used to relieve the symptoms of a migraine attack as it occurs. You may also see abortive migraine medications called acute migraine medications.

These drugs are most effective when taken at the onset of a migraine attack. For this reason, it is important to take them as soon as you feel the symptoms of migraine start to appear.

The specific type of abortion medication recommended will depend on several factors. These include things like the severity, frequency, and symptoms of your migraine.

Now let’s explore the different types of abortion treatments in more detail.

Over-the-counter (OTC) drugs

A variety of over the counter (OTC) medications can be used to treat a migraine attack. Here are some examples :

Over-the-counter medications are generally used as one of the first-line treatments for migraine. They are taken as a pill or an oral tablet.

These medications can usually help relieve mild migraine pain. However, if you have more intense migraines, they may not be as effective in relieving your symptoms.

The side effects of over-the-counter abortion medications depend on which one is used:

  • NSAIDs. Digestive side effects like upset stomach, nausea, and diarrhea are among the most common side effects of NSAIDs.
  • Acetaminophen. Some people can have an allergic reaction to acetaminophen. In rare cases, it can cause liver damage.
  • Caffeine (in combination pills). Some potential side effects of caffeine include nervousness, nausea, and dizziness.

Triptans

There are seven different types of triptans that have been approved by the Food and Drug Administration (FDA) for the treatment of migraine. They include:

  • sumatriptan (Imitrex)
  • rizatriptan (Maxalt)
  • zolmitriptan (Zomig)
  • almotriptan (Axert)
  • eletriptan (Relpax)
  • naratriptan (Amerge)
  • frovatriptan (Frova)

Triptans come in many different forms, including:

  • a pill or capsule
  • a tablet or cake that you dissolve on your tongue
  • nasal spray
  • An injection

Triptans are the preferred first-line abortion treatment for moderate to severe migraine pain. You will likely be prescribed a triptan if the over-the-counter medications have not been effective in relieving your migraine symptoms.

Some of the common side effects of triptans include:

  • tired
  • muscle pain (myalgia)
  • a feeling of pressure or tightness in the chest, jaw, or throat
  • a feeling of heaviness in the limbs

Ergot derivatives

There are two types of ergot derivatives that are used as an abortive treatment for migraine. These are dihydroergotamine (Migranal) and ergotamine tartrate.

Ergot derivatives are often used as a second-line abortion treatment. For example, you may be prescribed an ergot derivative if your migraine attacks do not respond well to over-the-counter medications or triptans.

Similar to triptans, ergot derivatives can be found in various forms, such as:

  • a pill or capsule
  • a tablet or cake that you dissolve on your tongue
  • nasal spray
  • An injection

Some of the potential side effects of ergot derivatives are:

Anti-nausea medications

Some people may experience migraines accompanied by nausea. For this reason, a few different anti-nausea drugs, also called antiemetics, may be prescribed in combination with an over-the-counter medicine, a triptan, or a rye ergot derivative.

Antinausea drugs are usually taken by mouth. Here are some examples of medications that can be used for migraine:

  • metoclopramide (Reglan)
  • prochlorperazine (Compazine)
  • chlorpromazine (Thorazine)

Possible side effects of anti-nausea medications can include:

In rare cases, a group of symptoms called extrapyramidal symptoms can occur with these medicines. Extrapyramidal symptoms can include tremors, involuntary muscle contractions, and involuntary movements.

Lasmiditan (Reyvow)

Lasmiditan (Reyvow) is a new migraine abortion drug that was approved by the FDA in October 2019. It is taken orally as a pill or capsule.

Some of the more common side effects of lasmiditan are:

  • tired
  • feel like sleeping
  • dizziness
  • paresthesia, feeling of pins and needles

Ubrogepant (Ubrelvy)

Ubrogepant (Ubrelvy) is another new type of migraine abortion medicine. It was approved by the FDA in December 2019. It is taken orally as a pill or capsule.

The most common side effects associated with ubrogepant are:

Now that we’ve covered the different types of migraine abortion medications, let’s take a look at how each type works.

Over-the-counter medications

Over-the-counter drugs used in the abortion treatment of migraine have different mechanisms of action:

  • NSAIDs. NSAIDs work by inhibiting an enzyme called cyclooxygenase (COX) 1 and 2. This blocks the production of chemicals called prostaglandins, which contribute to pain and inflammation.
  • Acetaminophen. Exactly how acetaminophen works to relieve symptoms such as pain and inflammation has not yet been determined.
  • Caffeine (in combination pills). Caffeine can work to constrict or constrict blood vessels. This can reduce blood flow to the brain, helping to relieve migraine symptoms. It also has anti-inflammatory properties.

Triptans

Triptans work by binding to certain types of receptors in the brain that are specific for the neurotransmitter serotonin.

When triptans bind to these receptors, the blood vessels in the brain constrict. This decreases the signaling of pain. Triptans can also reduce inflammation levels.

Ergot derivatives

Ergot derivatives work similarly to triptans in that they bind to certain serotonin receptors in the brain. This constricts blood vessels and reduces pain signaling.

However, ergot derivatives are less specific than triptans and can bind to other receptors as well. For this reason, they often have more side effects than triptans.

Antinausea drugs

Common types of anti-nausea medications used for migraine work by blocking a certain type of receptor in the brain. These are specific receptors for the neurotransmitter dopamine.

When these drugs bind to the dopamine receptor, they help prevent nausea or vomiting.

Lasmiditan (Reyvow)

Lasmiditan (Reyvow) works by targeting a specific serotonin receptor in the brain called 5-HT 1F. It is the first type of migraine medication to do this.

The exact mechanism by which lasmiditan relieves acute migraine symptoms is unknown.

Unlike triptans and rye ergot derivatives, lasmiditan does not constrict blood vessels. This can make it a good treatment option for people with health problems that impact the blood vessels.

Ubrogepant (Ubrelvy)

Ubrogepant (Ubrelvy) inhibits a receptor called the calcitonin gene-linked peptide receptor (CGRP). It is the first type of migraine abortion medication to work by this mechanism.

Ubrogepant prevents CGRP from binding to its receptor. When this happens, it helps stop the pain and vasodilation associated with migraine.

There are also several ways to prevent a migraine attack in the first place. Let’s take a look at these now.

Know and avoid your triggers

In many people, migraines occur in response to different triggers. Here are some examples of migraine triggers:

Knowing and avoiding your triggers is a good way to prevent a migraine. Depending on your specific migraine triggers, this usually involves specific lifestyle changes such as:

Take preventive medication

In addition to abortion medication, you can also take preventative migraine medications. When taken as directed, these medications can help prevent migraine attacks from occurring.

Here are some examples of preventative migraine medications:

Try dietary supplements

According to the National Center for Complementary and Integrative Health, several types of dietary supplements may be beneficial in helping prevent migraines. These are:

If you want to add dietary supplements to your migraine treatment plan, be sure to talk to your doctor first. They can tell you about any side effects or potential interactions with your current medications.

Migraine causes a recurring headache with intense throbbing or throbbing pain. Most of the time, it only affects one side of the head. Other symptoms may include nausea, vomiting, and sensitivity to lights, sounds, or smells.

Some people may also have a set of symptoms called aura that occurs before a migraine attack. Here are some examples of aura symptoms:

  • vision changes, such as seeing bright spots or partial vision loss
  • feeling of pins and needles in the face or hands
  • muscle weakness affecting one side of the body
  • difficulty speaking, such as mumbling or disturbing speech

Migraine attacks can be caused by a variety of triggers, including stress, hormonal changes, or sudden changes in weather. Without treatment, a migraine attack can last between 4 and 72 hours.

The exact cause of migraine is unknown. It is believed that changes in certain neurotransmitters, such as serotonin, play a role.

Abortion medications work to relieve the symptoms of a migraine attack. They are most effective when taken early, so be sure to take them as soon as you start to experience symptoms.

Typically, the first-line treatments for migraine are over-the-counter medications or triptans. Other medicines can be used if they are not effective in relieving your symptoms. You can also take medicines to relieve nausea that occurs with migraine.

It is important to take your abortion medication exactly as your doctor has told you to. If you find that you need to take them more than 3 times a week, make an appointment with your doctor to discuss this.


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