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When
a person experiences moderate or severe migraine headaches, a doctor
often recommends migraine-specific abortive medicines. These
abortive medicines are different from OTC analgesics.Rather than
relieving pain, they abort the headaches through a process of counteracting
the headache's cause--dilation of the person's temporal arteries. Triptans and ergot preparations are the two best-known migraine-specific
abortive medicines.
Triptans
attach to the person's serotonin receptors on nerves and blood vessels,
thus reducing inflammation and constricting blood vessels. This
process stops the headache. Sumatriptan (or "Imitrex")
is the triptan that has the longest history. It's available
in the U.S.as an oral tablet, nasal spray or injection. Zolmitriptan
and rizatriptan are more recently developed triptans that can be
obtained in pill form or as a melt-in-the-mouth tablet. Also,
almotriptan, naratriptan and frovatriptan can only be obtained as
oral tablets.
In the
past, triptans have been prescribed for moderate and severe headaches
once it was discovered that OTC analgesics and other measures were
not working. However, in more recent times, triptans have
been used as a first treatment for those with debilitating migraines. If you're using triptans, they should be taken early once
the migraine starts and if possible, before the pain gets very severe. The early in the attack that a triptan is used, the more effective
it will be. Used early enough, triptans can abort 80 percent
of migraines within two hours.
There
are, however, some side effects associated with triptans. These
include tingling of the skin, facial flushing, tightness around
the throat and chest, drowsiness, dizziness, and fatigue. These
side effects are almost always short-lived and are not serious.
Symptoms
which are obviously more serious are strokes and heart attacks. The effectiveness of triptans comes from the fact that they
narrow arteries located in the head--but unfortunately they might
also narrow arteries located in the heart. If an individual
already has an existing coronary or carotid artery disease, this
could reduce blood-flow and lead to possible stroke or heart attack. For this reason, triptans should never be used by patients
with a history of stroke or heart attack or patients with symptoms
of atherosclerosis. Talk with your doctor to learn more.Triptans should also not be used by pregnant women or children.
Like triptans, ergots are medicines which abort migraines.Some
examples include Wigraine, Ergomar, Cafergot, Migranal, and DH-45. As with triptans, ergots cause the blood vessels to constrict,
however ergots cause even more constrictions of vessels located
in the heart than triptans do--plus they have a more prolonged effect
on these heart vessels. This makes them riskier to use than
triptans. They also are more likely to cause nausea and vomiting.
Last,
midrin is a medication used to abort both migraine and tension headaches. It's actually a combination of acetaminophen (the pain reliever
round in Tylenol), isomethetene (a drug which constricts the blood
vessels) and dichloralphenazone (a sedative). It works best
when used early during the onset of the headache. However,
it's not recommended for those with high blood pressure because
of how it constricts the blood vessels. Those with kidney
disease, atherosclerosis, glaucoma, and liver disease likewise should
not take it.
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