here are three different levels of migraine treatment:
Preventative treatment (stopping attacks from happening)
Acute treatment (treating an attack as soon as it happens)
Rescue treatment (dealing with an attack if acute treatment does not work) .For acute treatment and for prophylaxis you need to consult neurologist
Patients should avoid factors that precipitate a migraine attack (eg, lack of sleep, fatigue, stress, certain foods, use of vasodilators). Encourage patients to use a daily diary to document the headaches. This is an effective and inexpensive tool to follow the course of the disease.
Patients may need to discontinue any medications that exacerbate their headaches. If an oral contraceptive
is suspected to be a trigger, the patient may be advised to modify, change, or discontinue its use for a trial period. Similarly, when hormone replacement therapy
is a suspected trigger, patients should reduce dosages, if possible. If headaches persist, consider discontinuing hormone therapy
Biofeedback, cognitive-behavioral therapy
, and relaxation therapy
are frequently effective against migraine headaches and may be used adjunctively with pharmacologic treatments. Occipital nerve stimulators may be helpful in patients who are refractory to other forms of treatment.