treatment for migraines includes therapies that may or may not involve medication. nonmedication therapies for migraine therapy that does not involve medications can provide symptomatic and preventative therapy. using ice biofeedback and relaxation techniques may be helpful at stopping an attack once it has started. if possible sleep is the best medicine. preventing migraine takes motivation for the patient to make some life changes. patients are educated as to triggering factors that can be avoided. these include smoking cessation avoiding certain foods especially those high in tyramine (sharp cheeses) or those containing sulphites (wines) or nitrates (nuts processed meats). generally leading a healthy lifestyle with good nutrition adequate fluid intake sufficient sleep and exercise may be useful. acupuncture has been suggested to be a useful nonmedication therapy. medication therapies for migraine individuals with occasional mild migraine headaches that do not interfere with daily activities usually medicate themselves with over-the-counter (otc nonprescription) pain relievers (analgesics). many otc analgesics are available. otc analgesics have been shown to be safe and effective for short-term relief of headache (as well as muscle aches pains menstrual cramps and fever) when used according to the instructions on their labels. there are two major classes of otc analgesics: acetaminophen (tylenol) and nonsteroidal anti-inflammatory drugs (nsaids). the two types of nsaids are aspirin and nonaspirin. examples of nonaspirin nsaids are ibuprofen (advil nuprin motrin ib and medipren) and naproxen (aleve). aspirin acetaminophen and caffeine also are available combined in otc analgesics for the treatment of headaches. examples of such combination analgesics are pain-aid excedrin fioricet and fiorinal. finding an effective analgesic or analgesic combination often is a process of trial and error because individuals respond differently to different analgesics. in general a person should use the analgesic that has worked in the past. this will increase the likelihood that an analgesic will be effective and decrease the risk of side effects. there are several precautions that should be observed with otc analgesics: children and teenagers should not use aspirin for the treatment of headaches other pain or fever because of the risk of developing reye's syndrome a life-threatening neurological disease that can lead to coma and even death. patients with balance disorders or hearing difficulties should avoid using aspirin because aspirin may aggravate these conditions. patients taking blood thinners such as warfarin (coumadin) should not take aspirin and nonaspirin nsaids without a doctor's supervision because they add further to the risk of bleeding that is caused by the blood thinner. patients with active ulcers of the stomach and duodenum should not take aspirin and nonaspirin nsaids because they can increase the risk of bleeding from the ulcer and impair healing of the ulcer. patients with advanced liver disease should not take aspirin and nonaspirin nsaids because they may impair kidney function. deterioration of kidney function in these patients can lead to kidney failure. patients should not overuse otc or prescription analgesics. overuse of analgesics can lead to the development of tolerance (increasing ineffectiveness of the analgesic) and rebound headaches (return of the headache as soon as the effect of the analgesic wears off usually in the early morning hours). thus overuse of analgesics can lead to a vicious cycle of more and more analgesics for headaches that respond less and less to treatment.
how are migraine headaches treated?