Migraines,headaches which involve intense throbbing pain, sometimes accompanied by visual disturbances as well as sensitivity to light and sounds, have been found to respond to a drug hitherto used to treat high blood pressure.
Clonidine (Arkamin)
This is another anti-hypertensive drug for migraine which is taken in a dose of one-eighth of that in hypertension. It is effective in only a small proportion of patients. Doses range from 0.025 mg to 0.05 mg, 2 to 3 times a day.
Adverse Effects: Adverse effects such as drowsiness, fall in blood pressure and dryness of the mouth are rare. Controlled clinical studies conducted in recent years have indicated that it does not produce any significant benefit.
Divalproex Sodium, (Diproex, Valance 125-250 mg), Sodium Valproate (Valparin 200 mg)
These dugs are anticonvulsants and are found to be effective antimigraine drugs. Long term use is associated with loss of hair, weakness and liver damage. Naproxen an analgesic drug, has been found to prevent recurrence also.
Other Drugs
Natural products such as feverfew - a medicinal herb and butterbur - a perennial shrub (75 mg extract) have also been tried. Feverfew has an active substance (parthenolide) that reduces serotonin release and the benefit is found to be substantial.
Botuilnum toxin type-A is a newer treatment which has shown 50 per cent reduction in mean frequency of headache. It is investigational and costly.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are among the first types of drugs tried to treat mild-to-moderate migraines. Studies have reported the following benefits for specific NSAIDs:
* Aspirin, ibuprofen, acetaminophen, and naproxen (Anaprox, Aleve) are all available without prescription, and have benefits for mild migraine. Naproxen appears to be more effective than other NSAIDs. In a study of children who had migraines, acetaminophen worked faster, but after 3 hours, ibuprofen was more effective.
* An NSAID combination, diclofenac-potassium (Cataflam)
, may work faster than the migraine drug sumatriptan (Imitrex) and help reduce nausea. The combination is not appropriate for people allergic to aspirin or at risk for bleeding.
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