Migraine treatment can never be achieved by medications only. Migraine requires a “management plan”, but not just treatment policy.
Migraine management requires two people in particular: the sufferer and the doctor. The migraine sufferer has a lot to contribute with, and the managing doctor needs to be open minded, to be clever, and above all to treat his patient as a human but not a migraine patient.
Behind the patient and the doctor stands the closest person to the sufferer; spouse (for the married), parents, mother in particular(for the unmarried), good friends, and people at work especially the employer.
Management of migraine needs many heads to work together (multi-disciplinary team), which includes in addition to the patient and the neurologist, patient’s doctor(GP), pharmacist, and a good psychologist. A psychiatrist with good knowledge of migraine may be required if needed.
The exact cause of migraine is not yet known apart from many “theories” including Calcitonin Gene-Related Peptide(CRGP), but with no convincing prove. All what we do doctors is to treat according to theoretical thinking(hypothesis). Hence, all medications we are using these days are very much subjected to failure i.e trials & errors.
The treatment of migraine can be divided into two main categories:
- Treating the acute attacks of migraine: Simple pain killers, Triptans, and other general measures such as calming, relaxing, changing the surrounding environment, sleeping, etc.
- Preventing migraine attacks to reduce their happening, or stop them from happening. There are many medications those can be used to prevent migraine such as Topiramate.
Other phases of migraine treatments:
- Botox Injections.
- CGRP antagonists; such as Eenumab(Aimovig), Fremanezumab(Ajvey), Galcanezumab, Eptinezmab, and Atogepant.
More will follow….