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Suggest Treatment For Severe Migraine

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Posted on Tue, 22 Mar 2016
Question: I have a terrible migrane.
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Answered by Dr. Olsi Taka (18 minutes later)
Brief Answer:
Read below

Detailed Answer:
I read your question and I am sorry about how you are feeling.

I wish you had provided some more info on your pain though. Is this the first time or has a diagnosis of migraine already been established. Keep in mind that not all headaches are migraine. Classical migraine is a pulsating disabilitating headache, with nausea or vomiting, increased sensitivity to lights and noise. Typically unilateral but variations are common. Attacks last 4-72 hours.

If you are unsure about what type of headache you have, please provide some more info on location, duration, manner of onset (sudden reaching maximum intensity in seconds/minutes or gradual), quality (throbbing, pressure-like, constant, lancinating), exacerbating or alleviating factors (head position, time of day, lack of sleep, light, sounds, physical activity, smells, foods, menstrual cycle etc), previous headaches or other conditions, past or present medication.

In the absence of other info, speaking of the treatment of a migraine attack, I would say that the best initial choice is over the counter anti-inflammatory pain killers (NSAIDs) like Ibuprofen.
If not effective and typical migraine with severe pain a class of medication called triptans is the chosen drug, most common representants are sumatriptan, zolmitriptan. If nausea and vomiting is an issue they are available also as nasal spray, or for sumatriptan also as patch or subcutaneous injections.
Another alternative to triptans would be DHE (dihydroergotamine) also available as nasal spray.
In some cases antiemetics (antivomiting) medication is also effective, like metoclopramide, chlorperazine. There are preparations on the market containing acetaminophen or a NSAID with an antiemetic.

In rebel severe cases where nothing works might need iv medication in the emergency room.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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Suggest Treatment For Severe Migraine

Brief Answer: Read below Detailed Answer: I read your question and I am sorry about how you are feeling. I wish you had provided some more info on your pain though. Is this the first time or has a diagnosis of migraine already been established. Keep in mind that not all headaches are migraine. Classical migraine is a pulsating disabilitating headache, with nausea or vomiting, increased sensitivity to lights and noise. Typically unilateral but variations are common. Attacks last 4-72 hours. If you are unsure about what type of headache you have, please provide some more info on location, duration, manner of onset (sudden reaching maximum intensity in seconds/minutes or gradual), quality (throbbing, pressure-like, constant, lancinating), exacerbating or alleviating factors (head position, time of day, lack of sleep, light, sounds, physical activity, smells, foods, menstrual cycle etc), previous headaches or other conditions, past or present medication. In the absence of other info, speaking of the treatment of a migraine attack, I would say that the best initial choice is over the counter anti-inflammatory pain killers (NSAIDs) like Ibuprofen. If not effective and typical migraine with severe pain a class of medication called triptans is the chosen drug, most common representants are sumatriptan, zolmitriptan. If nausea and vomiting is an issue they are available also as nasal spray, or for sumatriptan also as patch or subcutaneous injections. Another alternative to triptans would be DHE (dihydroergotamine) also available as nasal spray. In some cases antiemetics (antivomiting) medication is also effective, like metoclopramide, chlorperazine. There are preparations on the market containing acetaminophen or a NSAID with an antiemetic. In rebel severe cases where nothing works might need iv medication in the emergency room. I remain at your disposal for other questions.