How does aspirin work for migraine relief. What is the recommended dosage of aspirin for migraines. Are there any side effects of using aspirin for migraines. How does aspirin compare to other migraine treatments.

Understanding Aspirin’s Role in Migraine Treatment

Aspirin, a widely available nonsteroidal anti-inflammatory drug (NSAID), has emerged as a popular choice for migraine relief. Its accessibility, affordability, and effectiveness make it an attractive option for many individuals seeking respite from migraine pain. But how exactly does aspirin work to combat migraines?

Aspirin functions by inhibiting an enzyme responsible for producing prostaglandins, compounds involved in various bodily processes, including inflammation and pain sensation. By halting this production, aspirin effectively manages pain and reduces inflammation associated with migraines.

When to Take Aspirin for Migraines

Timing is crucial when using aspirin for migraine relief. For optimal results, individuals should take a single dose at the first sign of migraine symptoms. This prompt action aims to prevent the migraine from progressing, thereby minimizing pain intensity.

Can aspirin be used as a preventative measure for migraines? Some studies suggest that daily low-dose aspirin may help prevent recurrent migraines. However, the evidence supporting this approach remains mixed, and further research is needed to establish its long-term efficacy and safety.

Recommended Aspirin Dosages for Migraine Relief

Determining the right dosage of aspirin for migraine treatment is essential for achieving optimal relief while minimizing potential side effects. Recent research provides insights into effective dosing strategies:

• For acute migraine treatment: A single high dose of 900-1,300 milligrams (mg) is recommended.
• For migraine prevention: Daily low doses ranging from 81-325 mg may be considered, though evidence for this approach is inconclusive.

Is aspirin as effective as other migraine medications? A 2014 review comparing aspirin to sumatriptan, a common migraine-specific medication, found that 1,000 mg of aspirin provided comparable pain relief to a standard dose of sumatriptan. Interestingly, aspirin was associated with fewer side effects.

Potential Side Effects and Precautions of Aspirin Use

While aspirin is generally well-tolerated when used at safe dosages, it’s important to be aware of potential side effects and contraindications:

Common Side Effects

• Digestive irritation
• Indigestion
• Nausea

Less Common Side Effects

• Worsened asthma symptoms
• Shortness of breath
• Tinnitus (ringing in the ears)

Rare but Severe Side Effects

• Ulcers
• Gastrointestinal bleeding
• Severe allergic reactions

Who should avoid taking aspirin for migraines? Certain individuals should refrain from using aspirin, including:

• Children under 12 years old
• Children and adolescents with flu or chickenpox symptoms
• People with aspirin allergies or NSAID sensitivities
• Individuals with stomach ulcers
• Those with bleeding disorders
• Pregnant women (unless advised by a doctor)

It’s crucial to consult a healthcare professional before using aspirin if you have preexisting conditions such as asthma, digestive disorders, liver or kidney disease, or glucose-6-phosphate dehydrogenase deficiency.

Comparing Aspirin to Other Migraine Treatments

While aspirin has proven effective for many migraine sufferers, it’s essential to understand how it compares to other available treatments:

Other NSAIDs

NSAIDs are considered first-line treatments for mild-to-moderate migraines. How do other NSAIDs compare to aspirin in treating migraines?

• Ibuprofen (Advil, Motrin): Similar effectiveness to aspirin, with a slightly different side effect profile.
• Naproxen: Slower-acting but longer-lasting than aspirin.
• Diclofenac: May offer comparable relief to aspirin for some individuals.

Acetaminophen

Acetaminophen (Tylenol) is another common over-the-counter pain reliever. How does it stack up against aspirin for migraine treatment?

While acetaminophen may cause fewer side effects in some individuals, a 2018 review suggests it’s not as effective as NSAIDs, including aspirin, for migraine relief. However, for those unable to take NSAIDs, a combination of acetaminophen, aspirin, and caffeine may provide an alternative treatment option.

Triptans

Triptans are migraine-specific medications often prescribed for moderate-to-severe cases. How do they compare to aspirin in effectiveness?

The 2014 review mentioned earlier found that sumatriptan and aspirin demonstrated similar efficacy in treating migraines. However, triptans like sumatriptan, almotriptan, and zolmitriptan may be more suitable for individuals with severe migraines or those who don’t respond well to over-the-counter options.

Maximizing Aspirin’s Effectiveness for Migraine Relief

To optimize the benefits of aspirin for migraine treatment, consider the following strategies:

1. Early intervention: Take aspirin at the first sign of migraine symptoms for best results.
2. Proper dosing: Follow recommended dosages and avoid exceeding the maximum daily limit.
3. Stay hydrated: Drink plenty of water to help with medication absorption and minimize side effects.
4. Combine with rest: If possible, rest in a quiet, dark room after taking aspirin to enhance its effectiveness.
5. Consider caffeine: Some studies suggest that combining aspirin with caffeine may boost its pain-relieving properties.

Are there any lifestyle changes that can complement aspirin use for migraine management? Indeed, incorporating certain habits may enhance aspirin’s effectiveness and reduce migraine frequency:

• Maintaining a consistent sleep schedule
• Managing stress through relaxation techniques or meditation
• Regular exercise
• Identifying and avoiding personal migraine triggers
• Keeping a migraine diary to track patterns and treatment efficacy

Long-term Considerations for Aspirin Use in Migraine Treatment

While aspirin can be an effective short-term solution for migraine relief, it’s important to consider the implications of long-term use:

Medication Overuse Headache Risk

Frequent use of any pain medication, including aspirin, can lead to medication overuse headaches. How can this risk be mitigated?

• Limit aspirin use to no more than 2-3 days per week
• Consult a healthcare provider if migraine frequency increases
• Consider preventive treatments for chronic migraines

Gastric Protection

Long-term aspirin use may increase the risk of gastric issues. What measures can be taken to protect the stomach?

• Take aspirin with food or milk to reduce stomach irritation
• Consider using enteric-coated aspirin formulations
• Discuss the use of proton pump inhibitors with a doctor for added gastric protection

Regular Check-ups

Individuals using aspirin regularly for migraine management should schedule periodic check-ups with their healthcare provider to:

• Monitor for potential side effects
• Assess the ongoing effectiveness of the treatment
• Explore alternative or complementary therapies if needed

Emerging Research and Future Directions in Migraine Treatment

As our understanding of migraine pathophysiology evolves, new treatment approaches are continually being explored. How might future research impact the role of aspirin in migraine management?

Personalized Medicine Approaches

Ongoing research aims to identify genetic markers that may predict an individual’s response to specific migraine treatments, including aspirin. This could lead to more tailored treatment plans in the future.

Novel Drug Combinations

Scientists are investigating new combinations of existing medications, including aspirin, to enhance efficacy and reduce side effects. For example, combining aspirin with certain supplements or other pharmaceuticals may yield promising results.

Alternative Delivery Methods

Research into new drug delivery systems, such as transdermal patches or nasal sprays, may offer alternative ways to administer aspirin or similar compounds for migraine relief, potentially improving absorption and reducing gastrointestinal side effects.

Integrating Aspirin into a Comprehensive Migraine Management Plan

While aspirin can be an effective tool for managing migraines, it’s important to view it as part of a broader treatment strategy. How can aspirin be incorporated into a comprehensive migraine management plan?

Multimodal Approach

Combining pharmacological treatments like aspirin with non-pharmacological interventions can enhance overall migraine management. Consider integrating the following approaches:

• Cognitive-behavioral therapy for stress management
• Acupuncture or massage therapy for pain relief
• Biofeedback techniques for migraine prevention
• Dietary modifications to avoid potential trigger foods

Preventive Strategies

For individuals with frequent migraines, aspirin may be used in conjunction with preventive medications or treatments. How can this be implemented effectively?

• Discuss the potential use of daily low-dose aspirin with a healthcare provider
• Consider combining aspirin with other preventive medications as recommended by a neurologist
• Explore the use of supplements like magnesium or riboflavin alongside aspirin for migraine prevention

Emergency Plan

Developing a structured plan for managing severe migraine attacks can help individuals respond effectively when aspirin alone may not suffice. What should this plan include?

• A step-by-step protocol for escalating treatment if initial aspirin dose is ineffective
• Guidelines for when to seek medical attention or emergency care
• A list of alternative medications or rescue treatments to use if aspirin is contraindicated or ineffective

By integrating aspirin into a comprehensive migraine management strategy, individuals can maximize its benefits while addressing the multifaceted nature of migraine treatment.

Patient Education and Self-Management Techniques

Empowering patients with knowledge and self-management skills is crucial for effective migraine treatment. How can individuals enhance their ability to manage migraines when using aspirin?

Understanding Migraine Phases

Educating patients about the different phases of a migraine attack can help them identify the optimal time to take aspirin. What are the key phases to be aware of?

• Prodrome: Early warning signs that a migraine is imminent
• Aura: Sensory disturbances that may precede or accompany the headache phase
• Headache: The main phase of pain and associated symptoms
• Postdrome: The recovery phase following the headache

Recognizing these phases can help individuals time their aspirin intake for maximum effectiveness.

Trigger Identification and Avoidance

Teaching patients to identify and avoid personal migraine triggers can reduce the frequency of attacks and the need for medication. What are some common migraine triggers to watch for?

• Certain foods and beverages (e.g., aged cheeses, red wine, caffeine)
• Hormonal changes
• Weather changes
• Lack of sleep or changes in sleep patterns
• Stress and emotional factors

Lifestyle Modifications

Encouraging patients to adopt lifestyle habits that support migraine management can complement the use of aspirin. What lifestyle changes can be beneficial?

• Maintaining a regular sleep schedule
• Engaging in moderate, regular exercise
• Practicing stress-reduction techniques like meditation or yoga
• Staying hydrated and maintaining a balanced diet
• Limiting screen time and managing digital eye strain

Migraine Diary

Teaching patients to keep a detailed migraine diary can provide valuable insights into their condition and treatment efficacy. What information should be recorded in a migraine diary?

• Date and time of migraine onset
• Intensity and duration of pain
• Associated symptoms
• Medications taken (including aspirin) and their effectiveness
• Potential triggers or contributing factors

By empowering patients with these self-management techniques, healthcare providers can help individuals optimize their use of aspirin and improve overall migraine management.

How it works, dosages, side effects, and more

People can take a range of medications for migraine, including nonsteroidal anti-inflammatory drugs such as aspirin. For many, aspirin is an affordable, convenient, and effective migraine treatment.

It is available over the counter (OTC) and on prescription. However, this medication is not suitable for everyone.

This article offers an overview of taking aspirin for migraine, including how it works, dosages, and side effects. It also looks at how it compares with other migraine treatments.

People can take aspirin, a common nonsteroidal anti-inflammatory drug (NSAID), to stop the progression of migraine. Typically, a person takes a single dose as soon as they feel symptoms developing. The aim is to prevent the progression of the migraine to reduce pain.

Aspirin may also work as a preventative medication when taken daily at lower doses, although evidence on the effectiveness of this approach is mixed.

Aspirin works by blocking an enzyme that makes the body produce prostaglandins, which are compounds with many bodily functions, including inflammation and pain processes. By stopping this production process, aspirin can control pain and inflammation.

People generally use aspirin for mild-to-moderate migraine that does not trigger nausea or vomiting, as vomiting may mean they do not absorb the medication. Those who experience vomiting during migraine episodes may need antiemetics to ensure the body can absorb other medicines.

A 2020 review states that people using aspirin as a treatment for current migraine symptoms can take a single high dose between 900–1,300 milligrams (mg).

The review also states it is possible to take aspirin daily at lower doses to prevent recurring episodes. However, the evidence is mixed for this approach. People who wish to try this method can take between 81–325 mg per day.

A 2014 review of previous research found that taking 1,000 mg of aspirin was comparable to a standard dose of sumatriptan in terms of acute pain relief. Aspirin also caused fewer side effects than sumatriptan.

In the review, out of 2,027 participants from six studies, 24% were pain-free 2 hours after taking aspirin, compared to 11% taking a placebo.

Many people who take aspirin tolerate it well at safe dosages. However, as with all NSAIDs, it can lead to side effects.

While the 2014 review found that aspirin had fewer side effects than sumatriptan, aspirin has the highest risk of side effects out of all NSAIDs available for migraine.

The most common side effects of aspirin are:

• digestive irritation
• indigestion
• nausea

Less commonly, people can experience:

• worsened asthma symptoms
• shortness of breath
• tinnitus

Rarely, severe adverse effects include:

• ulcers
• gastrointestinal bleeding
• severe allergic reactions

A 2018 review cautions against using OTC pain medications for long periods. If a person experiences migraine episodes or headaches frequently, they may need to consider other options.

Some people should not take aspirin, including:

• children under 12 years old
• children and adolescents with symptoms of flu or chickenpox
• people who are allergic or sensitive to NSAIDs
• people with stomach ulcers
• people with bleeding disorders, such as hemophilia
• people who are pregnant, unless otherwise instructed by a doctor

Children and adolescents should not use aspirin because the medication has links with Reye’s syndrome. People with this condition may develop swelling in the brain, which can lead to coma and even death.

People should speak with a doctor before trying aspirin if they have a preexisting condition, such as:

• asthma
• digestive conditions
• liver or kidney disease
• glucose-6-phosphate dehydrogenase deficiency, as aspirin may trigger anemia in these individuals

Certain medications may also interact with aspirin. If someone takes existing medicines, speak with a doctor or pharmacist before using aspirin.

NSAIDs

NSAIDs are a first-line treatment for mild-to-moderate migraine. Examples that doctors and pharmacists may recommend include:

• ibuprofen (Advil, Motrin)
• naproxen
• diclofenac

Naproxen is the slowest acting NSAID, but it has the longest duration of action. Aspirin works more quickly, but does not last as long.

Acetaminophen

Acetaminophen (Tylenol) is not an NSAID, but a common OTC pain medication that may help with migraine pain.

A 2018 review notes that acetaminophen is not as effective as NSAIDs for treating migraine. However, it may cause fewer side effects in some people.

Those who cannot take other types of migraine medication may instead try a combined regimen of acetaminophen, aspirin, and caffeine.

Triptans

People with moderate-to-severe migraine may require triptans. These medications work specifically for migraine, including drugs such as:

• sumatriptan
• almotriptan
• zolmitriptan

The 2014 review found that sumatriptan and aspirin are similarly effective for migraine. However, they come with their own side effects and risks, particularly if people combine them with medications that affect serotonin levels, such as certain antidepressants.

Other medications for migraine include:

• ergots, such as ergotamine and dihydroergotamine
• dexamethasone, a steroid that does not reduce immediate pain but can reduce the frequency of migraine episodes
• calcitonin gene-related peptide antagonists
• opioids, although the 2018 review notes these should be a last resort

Sometimes, migraine headaches or episodes are unavoidable. While people do not always understand what causes them, they can try to identify specific triggers and find relief with diet or lifestyle changes.

Keep a migraine diary to record symptoms when they occur, alongside any factors that may have contributed to migraine that day. Over time, a person may notice a pattern.

Factors that may lead to migraine include:

• stress
• hormonal changes
• specific foods, such as cheese or chocolate
• strong smells or tastes
• bright lights
• skipped meals
• weather changes
• being too hot
• too much or not enough sleep
• drinking alcohol
• cigarette smoke
• exercise
• sex

In some people, muscle tension can also trigger migraine headaches. However, if a person’s headaches often precede neck pain, they may be experiencing cervicogenic headaches. These feel similar to migraine, but nerve, muscle, or bone issues in the neck are the cause.

Depending on a person’s triggers, they may be able to reduce the frequency of migraine episodes with:

• yoga
• relaxation training
• physical therapy
• biofeedback
• sleep aids such as melatonin
• dietary changes
• stopping smoking or drinking

Migraine pain can be severe, but severe pain can sometimes indicate another condition that requires medical treatment.

Anyone experiencing the following should seek emergency help:

• a headache that feels excruciating or comes on suddenly
• a severe headache that gets increasingly severe
• seizures
• symptoms of a severe allergic reaction, such as swollen airways and trouble breathing

It is also important to speak with a doctor promptly if:

• a person is over 50 years old when migraine episodes begin
• they have symptoms of other disorders, such as high blood pressure, weight loss, or other pain
• they have signs of infection, such as fever

People experiencing these symptoms may need a referral to a specialist.

If a person has any new symptoms while taking aspirin, stop taking it and speak with a doctor as soon as possible.

Aspirin can be an effective and affordable migraine treatment. People often use it in a single high dose to prevent migraine headaches or episodes from getting worse.

However, this medication is not suitable for everyone, so check with a doctor before taking it. A healthcare professional or pharmacist can recommend the best dosage and advise on alternatives if aspirin triggers side effects or is not effective.

How it works, dosages, side effects, and more

People can take a range of medications for migraine, including nonsteroidal anti-inflammatory drugs such as aspirin. For many, aspirin is an affordable, convenient, and effective migraine treatment.

It is available over the counter (OTC) and on prescription. However, this medication is not suitable for everyone.

This article offers an overview of taking aspirin for migraine, including how it works, dosages, and side effects. It also looks at how it compares with other migraine treatments.

People can take aspirin, a common nonsteroidal anti-inflammatory drug (NSAID), to stop the progression of migraine. Typically, a person takes a single dose as soon as they feel symptoms developing. The aim is to prevent the progression of the migraine to reduce pain.

Aspirin may also work as a preventative medication when taken daily at lower doses, although evidence on the effectiveness of this approach is mixed.

Aspirin works by blocking an enzyme that makes the body produce prostaglandins, which are compounds with many bodily functions, including inflammation and pain processes. By stopping this production process, aspirin can control pain and inflammation.

People generally use aspirin for mild-to-moderate migraine that does not trigger nausea or vomiting, as vomiting may mean they do not absorb the medication. Those who experience vomiting during migraine episodes may need antiemetics to ensure the body can absorb other medicines.

A 2020 review states that people using aspirin as a treatment for current migraine symptoms can take a single high dose between 900–1,300 milligrams (mg).

The review also states it is possible to take aspirin daily at lower doses to prevent recurring episodes. However, the evidence is mixed for this approach. People who wish to try this method can take between 81–325 mg per day.

A 2014 review of previous research found that taking 1,000 mg of aspirin was comparable to a standard dose of sumatriptan in terms of acute pain relief. Aspirin also caused fewer side effects than sumatriptan.

In the review, out of 2,027 participants from six studies, 24% were pain-free 2 hours after taking aspirin, compared to 11% taking a placebo.

Many people who take aspirin tolerate it well at safe dosages. However, as with all NSAIDs, it can lead to side effects.

While the 2014 review found that aspirin had fewer side effects than sumatriptan, aspirin has the highest risk of side effects out of all NSAIDs available for migraine.

The most common side effects of aspirin are:

• digestive irritation
• indigestion
• nausea

Less commonly, people can experience:

• worsened asthma symptoms
• shortness of breath
• tinnitus

Rarely, severe adverse effects include:

• ulcers
• gastrointestinal bleeding
• severe allergic reactions

A 2018 review cautions against using OTC pain medications for long periods. If a person experiences migraine episodes or headaches frequently, they may need to consider other options.

Some people should not take aspirin, including:

• children under 12 years old
• children and adolescents with symptoms of flu or chickenpox
• people who are allergic or sensitive to NSAIDs
• people with stomach ulcers
• people with bleeding disorders, such as hemophilia
• people who are pregnant, unless otherwise instructed by a doctor

Children and adolescents should not use aspirin because the medication has links with Reye’s syndrome. People with this condition may develop swelling in the brain, which can lead to coma and even death.

People should speak with a doctor before trying aspirin if they have a preexisting condition, such as:

• asthma
• digestive conditions
• liver or kidney disease
• glucose-6-phosphate dehydrogenase deficiency, as aspirin may trigger anemia in these individuals

Certain medications may also interact with aspirin. If someone takes existing medicines, speak with a doctor or pharmacist before using aspirin.

NSAIDs

NSAIDs are a first-line treatment for mild-to-moderate migraine. Examples that doctors and pharmacists may recommend include:

• ibuprofen (Advil, Motrin)
• naproxen
• diclofenac

Naproxen is the slowest acting NSAID, but it has the longest duration of action. Aspirin works more quickly, but does not last as long.

Acetaminophen

Acetaminophen (Tylenol) is not an NSAID, but a common OTC pain medication that may help with migraine pain.

A 2018 review notes that acetaminophen is not as effective as NSAIDs for treating migraine. However, it may cause fewer side effects in some people.

Those who cannot take other types of migraine medication may instead try a combined regimen of acetaminophen, aspirin, and caffeine.

Triptans

People with moderate-to-severe migraine may require triptans. These medications work specifically for migraine, including drugs such as:

• sumatriptan
• almotriptan
• zolmitriptan

The 2014 review found that sumatriptan and aspirin are similarly effective for migraine. However, they come with their own side effects and risks, particularly if people combine them with medications that affect serotonin levels, such as certain antidepressants.

Other medications for migraine include:

• ergots, such as ergotamine and dihydroergotamine
• dexamethasone, a steroid that does not reduce immediate pain but can reduce the frequency of migraine episodes
• calcitonin gene-related peptide antagonists
• opioids, although the 2018 review notes these should be a last resort

Sometimes, migraine headaches or episodes are unavoidable. While people do not always understand what causes them, they can try to identify specific triggers and find relief with diet or lifestyle changes.

Keep a migraine diary to record symptoms when they occur, alongside any factors that may have contributed to migraine that day. Over time, a person may notice a pattern.

Factors that may lead to migraine include:

• stress
• hormonal changes
• specific foods, such as cheese or chocolate
• strong smells or tastes
• bright lights
• skipped meals
• weather changes
• being too hot
• too much or not enough sleep
• drinking alcohol
• cigarette smoke
• exercise
• sex

In some people, muscle tension can also trigger migraine headaches. However, if a person’s headaches often precede neck pain, they may be experiencing cervicogenic headaches. These feel similar to migraine, but nerve, muscle, or bone issues in the neck are the cause.

Depending on a person’s triggers, they may be able to reduce the frequency of migraine episodes with:

• yoga
• relaxation training
• physical therapy
• biofeedback
• sleep aids such as melatonin
• dietary changes
• stopping smoking or drinking

Migraine pain can be severe, but severe pain can sometimes indicate another condition that requires medical treatment.

Anyone experiencing the following should seek emergency help:

• a headache that feels excruciating or comes on suddenly
• a severe headache that gets increasingly severe
• seizures
• symptoms of a severe allergic reaction, such as swollen airways and trouble breathing

It is also important to speak with a doctor promptly if:

• a person is over 50 years old when migraine episodes begin
• they have symptoms of other disorders, such as high blood pressure, weight loss, or other pain
• they have signs of infection, such as fever

People experiencing these symptoms may need a referral to a specialist.

If a person has any new symptoms while taking aspirin, stop taking it and speak with a doctor as soon as possible.

Aspirin can be an effective and affordable migraine treatment. People often use it in a single high dose to prevent migraine headaches or episodes from getting worse.

However, this medication is not suitable for everyone, so check with a doctor before taking it. A healthcare professional or pharmacist can recommend the best dosage and advise on alternatives if aspirin triggers side effects or is not effective.

Pain relief for migraine

• painkillers, and most of them are sold without prescription. Below we will review the rules for the relief of migraine attacks , which will help you navigate the rich variety of analgesics and abandon undereffective drugs.

  A stepwise approach to treatment of migraine attacks is currently preferred .

  In this case, the patient starts with the cheapest, safest, and proven drugs and moves up the ladder to the next class of drugs only when needed.

  This method does not deny an individual approach to each patient, but, on the contrary, makes it possible to find the most suitable drug for each patient. It is suggested that if a particular remedy fails to relieve pain in three attacks, the next attack should immediately begin at a higher level.

  Moreover, many patients have seizures of varying intensity . For example, in most patients , menstrual migraine attacks (those that occur 1-2 days before or on the first or second day of menstruation) tend to be more severe. Such patients need anesthesia of higher levels at the very beginning of a menstrual attack.

  Ideally, requires rest or sleep after taking the medicine.

  For patients who need to stay at work or do important things at home, it is better to choose drugs that do not affect concentration.

  I. First-line analgesic

  Non-specific analgesic ± antiemetic

  High doses of analgesics are usually required to stop a migraine attack , since the absorption of drugs may be slowed down due to gastrostasis.

  1a. Simple analgesic ± antiemetic

  The gold standard for migraine pain relief is acetylsalicylic acid.

  A high dose of 1000 mg is needed to stop a migraine attack. 2 tablets of 500 mg. A soluble form of acetylsalicylic acid is preferred.

  The effectiveness of aspirin was shown in a recent systematic review by the Cochrane Society, a standard-setting organization in the world of evidence-based medicine.

  An alternative to acetylsalicylic acid is ibuprofen at a dose of at least 400-600 mg. Clinical experience shows that patients usually take lower doses of 200-400 mg, which is why they are disappointed with this drug. Acetylsalicylic acid and ibuprofen can be taken up to 4 times in 24 hours.

  • naproxen 750-825 mg once, with an option to take another 250 mg 2 times over the next 24 hours;

  • diclofenac potassium 50-100 mg, daily dose may be up to 200 mg. This drug has a definite advantage.

  Due to the rapid development of gastrostasis and consequent slowing of drug absorption during a migraine attack, resorbable or soluble forms of pain medication are preferred. In Russia, none of the painkillers is registered in the form of lingual tablets. Diclofenac Potassium is available as a soluble powder at the same time, taking gives a faster effect . In 2010, data from a study were published that showed that administration of soluble diclofenac potassium leads to an effective reduction in pain intensity after 30 minutes. Such a rapid effect may be due to the fact that the maximum concentration of soluble diclofenac potassium in plasma is reached 15 minutes after administration. The duration of the effect of the drug in the study exceeded 24 hours.

  Paracetamol is less effective and should not be used as a drug of first choice for the relief of migraine attacks.

  All pain medications must be combined with prokinetic . Such drugs fight gastrostasis during a migraine attack, accelerate the passage of the analgesic from the stomach to the intestines, which makes it possible to accelerate the onset of their analgesic effect and minimize irritation of the gastric mucosa.

  For this purpose you can use:

  • metoclopramide 10 mg (1 tablet). The drug is available under trade names cerucal , metoclopramide and raglan ;

  • domperidone 10-20 mg (1-2 tablets). The drug is available under the trade names domperidone and motilium . The use of domperidone is more preferable, since the drug rarely causes extrapyramidal disorders. If taken later, these drugs also reduce the feeling of nausea.

  The analgesic effect of drugs can also be strengthen by adding caffeine . It has been shown that the addition of 130 mg of caffeine to the usual dose of painkillers ( aspirin and paracetamol ) increases the effectiveness of their analgesic action by 40%. Caffeine also improves the absorption of these drugs, speeding up the onset of their effect. That is why the combination non-specific analgesic + prokinetic must be supplemented with caffeinated drink . For example, freshly brewed coffee (200 ml) contains 65-135 mg caffeine, espresso (60 ml) – 100 mg caffeine, tea (200 ml) – 40-60 mg, hot cocoa (200 ml) – 14 mg, cola (330 ml) – 30-50 mg, Red Bull™ (230 ml) – 80 mg caffeine . The analgesic effect of can also be enhanced by the addition of glucose . That is why in Western countries it is recommended to dissolve aspirin in a sweet caffeine-containing carbonated drink.

  Contraindications: specific contraindications to non-steroidal anti-inflammatory drugs (eg gastric ulcer). Avoid giving aspirin to children under 12 years of age. Metoclopramide is also not used in children.

  1b. Combination analgesic ± antiemetic

  Combination pain medications are also registered in Russia. All these preparations contain caffeine . The drug Citramon is very popular. It contains: paracetamol 180 mg + caffeine 30 mg + acetylsalicylic acid 240 mg. The preparation askofen P is practically similar in composition to citramon. To achieve the optimal analgesic effect, it is advisable to take 2 tablets of Citramon.

  It should be noted that the European Guidelines for the treatment of migraine attacks do not include all combined preparations. At the same time, the drug Excedrin 9 is used in the USA0042, almost completely corresponding in composition to citramon. In case of insufficient effectiveness of single-component analgesics, the use of Citramon can be recommended, but only for those patients who do not need to take this drug more than 2 times a week.

  1c. Non-specific analgesic in suppositories – antiemetic

  Pain medications are also available in the form of suppositories. This helps ensure they are well absorbed during nausea and vomiting. Available as rectal suppositories voltaren 100 mg (diclo-fenac). Up to 200 mg can be used in 24 hours.

  Clinical experience shows that many patients seek medical advice when their usually combined analgesics are ineffective. In this case, there is usually an increase in the dose and frequency of taking painkillers, which in the short term leads to the formation of drug-induced headache . That is why, in case of insufficient effectiveness of the first stage of anesthesia, it is necessary to transfer the patient to the second stage – specific anti-migraine analgesics. Today, in the era of the advent of generic triptans , these drugs are becoming more affordable for different categories of patients.

  II. Second stage pain relief

  Specific anti-migraine analgesics

  Specific anti-migraine analgesics – triptans – are selective 5-HT1 receptor agonists. Although all triptans have the same site of application, some patients respond to only 1 or 2 different drugs, so the final choice of drug must be left to the patient. This choice may be influenced by the rate of onset of the analgesic effect, as well as financial reasons. Ideally, each triptan should be taken in 3 attacks before a final conclusion can be drawn about its effectiveness.

  Triptans should be taken after the end of the aura. At the same time, their effectiveness is maximum in the case of early administration (no later than 2 hours after the onset of headache). Pain returns within 48 hours in 20–50% of patients. Triptan may be combined with the prokinetic drug metoclopramide or domperidone. Triptans should only be taken if the patient is completely certain that the attack is a migraine. If the pain grows slowly and there is no such certainty, you need to start with a non-specific analgesic.

  Sumatriptan was the first in this class. Today it is the most researched drug, in addition, generic sumatriptan drugs have appeared, the cost of which is significantly lower than the cost of original drugs.

  All triptans currently registered in Russia are presented in the table.

  In a study conducted in Russia, in the case of early use of sumamigren, a significant decrease in headache and associated symptoms ( nausea , photophobia , phonophobia ) was observed already 1 hour after taking sumamigren. Thus, the intensity of headache decreased from 7.1±1.7 to 4.9+2.1 points (on a 10-point scale), nausea — from 5.4+2.7 to 3.7+ 2.1, photophobia — from 5.7+2.3 to 3.7+1.7, phonophobia — from 5. 3±2.3 to 3.4±2.2 points. The intensity of headache with concomitant symptoms significantly decreased 2 and 6 hours after taking sumamigren: after 2 hours, the intensity of cephalalgia was 2.7+1.3, and after 6 hours it was 1.3+1.4 points (Fig. 1 and 2).

  In view of such high efficiency, comparable with the effect of the original drug (direct comparative studies have not been conducted), an important advantage of sumamigren is its significantly lower cost – approximately 150-180 rubles per package of 2 tablets of 50 mg.

  Naratriptan is slower acting than other drugs and may be used if other drugs cause side effects.

  Contraindications: Triptans are contraindicated in cases of uncontrolled hypertension, significant risk factors for cardiovascular disease (history of stroke or myocardial infarction, advanced age, anti-phospholipid syndrome). In the absence of these contraindications, the risk associated with taking triptans is very low.

  In case of ineffectiveness of the second stage of anesthesia, it is necessary to confirm the diagnosis, pay attention to the time of taking the drugs, and suggest preventive treatment.

  III. Third-degree pain relief

  Combination of simple analgesic and triptan

  There is evidence that the combination of sumatriptan 50 mg and naproxen 500 mg may be more effective than sumatriptan alone. Such a scheme can be offered, for example, to patients who experience pain or discomfort in the neck during an attack, as well as during menstrual migraine attacks, if the patient also experiences periodic abdominal pain.

  Classic method for migraine relief:

  • Acetylsalicylic acid 1000 mg + motilium 10 mg + sweet caffeine-containing drink.

  • If pain is not relieved after 45 minutes, triptan (1 tablet) should be taken.

  • It is recommended to take a triptan immediately if a non-specific analgesic has not been effective for 3 attacks in a row.

  In the case of migraine with aura, aspirin should be taken after the onset of the aura, and triptans – after onset of headache .

  • Acupuncture for migraine
  • Reflexology in the clinic
  • How to help a child during a migraine attack
  • How to treat panic attacks in pregnant women
  • Causes of migraine
  • Migraine : symptoms and treatment
  • Migraine in women and menstrual migraine
  • Treatment migraine in the clinic. Veyna
  • Tension headache
  • Abuse headache
  • Medicines for migraine and headaches
  • Treatment of depression
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  • How to deal with panic attacks?
  • Treatment of panic attacks and panic attacks in Moscow
  • Psychotherapy in the clinic
  • Headache – treatment
  • Treatment of VSD and panic attacks
  • Treatment of facial pain
  • Trigeminal nerve treatment
  • Neurology Center
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  • Why do you need a consultation with a neurologist in Moscow?
  • Pain management

  Migraine medication

  There are over 200 types of headaches and many possible triggers that cause them. The range of drugs for headaches and migraine attacks is large, so choosing the best one is difficult. What helps to quickly and effectively relieve pain? Is there a perfect migraine cure? In fact, only the patient himself can give an answer, the reaction of the body to each drug is very individual.

  To facilitate the decision on the choice of drugs, we can use the following conclusion – for a migraine attack, combined analgesics (acetylsalicylic acid, paracetamol, ibuprofen and caffeine) are the drugs of first choice. This conclusion is the result of serious research by headache companies in German-speaking countries (German Migraine and Headache Society, Austrian Headache Society, Swiss Headache Society).

  Ibuprofen

  Ibuprofen is a modern active ingredient for the treatment of pain. It is used very frequently and is recommended by the experts of the German Migraine and Headache Society (DMKG) as the first choice for the treatment of migraine and tension headache. Ibuprofen may also be used as a suppository for associated nausea. A good effect from it is noticeable with mild or moderate pain, but it is especially useful if inflammation is observed at the same time. The recommended dosage for acute headache in self-treatment is 400 mg.

  Paracetamol

  Paracetamol is a long-acting analgesic. It is widely used throughout the world and has shown good results in mild to moderate pain. In acute headache, doses of 500-1000 mg are recommended, depending on its intensity. Since paracetamol also has an antipyretic component and is well tolerated at the recommended age dosage, it is often used in children. For migraine attacks with vomiting, paracetamol can be used as a suppository. The mechanism by which the drug relieves headache pain is unclear.

  Acetylsalicylic acid

  Acetylsalicylic acid is a classic analgesic. For headaches, the drug has been considered the drug of choice for decades. In addition to its analgesic component, aspirin is used for its blood-thinning effect in low doses to prevent circulatory disorders. The recommended dose for adults with acute headache is 1000 mg (depending on the severity of pain)

  Caffeine for headache

  Espresso with lemon at the start of a migraine attack? Could this really help? In fact, caffeine can relieve headaches, which is now scientifically proven. But anyone who thinks they can just “wash down” a headache pill with a cup of espresso is wrong. Because the amount of caffeine varies greatly depending on the type of coffee and its preparation.

  Caffeine is widely used as an active ingredient in pain relievers in combination with paracetamol and aspirin for headaches. Here it not only acts as an anesthetic, but also enhances the effectiveness of other components. In addition, caffeine acts as a vasodilator, a factor that can help a headache sufferer. In general, adding 100mg of caffeine to a pain reliever can provide an additional analgesic effect, roughly equivalent to doubling the analgesic dose. Caffeine enters our bloodstream very quickly – after 30-45 minutes it can already be detected in the blood. The substance is distributed in the body, remains there for about four hours, and then again excreted in the urine. Today, scientists are discussing whether caffeine itself can have an analgesic effect?

  Combination preparations for migraine

  In the treatment of migraine, the combination of caffeine with classic pain relievers such as aspirin, paracetamol and ibuprofen shows good results. In this case, caffeine, among other things, acts as a kind of “accelerator”. By enhancing the absorption of active ingredients into the blood, it allows you to achieve a faster effect. Another advantage in the treatment of headaches with combination preparations is that the amount of active ingredient of the individual substances per tablet can be kept lower than in the respective individual preparations.

  New clinical data show that ibuprofen 400 mg plus medicated caffeine 100 mg is faster and more effective than ibuprofen alone. The combination outperforms ibuprofen alone by 40 percent.