Migraine
Migraine, severe headache that occurs periodically and is sometimes confined to only one side of the head. A migraine is characterized by intense, throbbing, often blinding pain, and one or more of the following symptoms: sensitivity to light, nausea, vomiting, chills, facial swelling, tenderness of the scalp, sweating, frequent urination, irritability, visual hallucinations, and malaise. The headache may be preceded by a warning sensation, known as an aura, that may include flashes or patterns before the eyes,
illusory tastes or odors, dizziness, tingling, or numbness.
More than 26 million people in the United States suffer from migraines, which can last for hours or days at a time and recur at intervals ranging from one day to several years. Women are twice as likely as men to experience these headaches, and some evidence suggests that migraines are inherited. They tend to affect people for the first time between the ages of 10 and 30; symptoms tend to become far less intense after the age of 50.
At the onset of a migraine headache, blood vessels within the head constrict, causing a decrease in blood flow to the surface of the brain. Swelling of blood vessels in the head and scalp then sets off a chain of reactions that result in the headache. Among the biochemical changes associated with migraines are a reduced level of the neurotransmitter serotonin as well as an insufficient supply of enkephalins, the brain’s pain-relieving chemicals.
Hormonal level changes (such as those experienced by women during menopause or menstruation), endocrine imbalances, and stress due to anything from overwork to loud noises are considered precipitating factors of migraine headaches in susceptible people. Other factors that may trigger attacks include allergies, excess carbohydrates in the diet, foods rich in the trace element iodine, and alcoholic beverages.
Treatment
Several treatments have been successful in helping migraine sufferers. These include medications such as sumatriptan and ergotamine tartrate, both of which shrink swollen blood vessels, thereby aborting the acute phase of a migraine attack; and propranolol, which stabilizes blood vessel tone and helps prevent subsequent attacks. Other drugs often prescribed to migraine sufferers are amitriptyline, phenelzine, and verapamil. Biofeedback techniques have also proven useful.
1.Anti Convulsants
Carbamazepine
Carbamazepine or Tegretol, prescription drug used to treat seizures such as those associated with epilepsy. It also relieves neuralgia, or pain along a sensory nerve, in the jaw, tongue, or throat. The drug is occasionally prescribed for patients recovering from alcohol or cocaine addiction, for migraine headaches, and for depression or other emotional disorders. It works by suppressing impulses along nerve fibers in the brain, making seizures less frequent and less severe. It also prevents the transmission of certain nerve impulses, thereby reducing pain.
Carbamazepine is taken orally and is available in tablet form, usually taken twice a day, or liquid form, usually taken four times a day. Both forms should be taken with meals. Daily dosages for control of seizures range from 800 to 1200 mg, the higher recommended dose for adults and children over the age of 12. For neuralgia, doses of 400 to 800 mg per day are usually effective. The drug is typically prescribed in small doses in the beginning, which are increased daily or weekly until symptoms are relieved. This process may take three months or more. Children six years and older may take this drug, although it is usually prescribed in smaller amounts. The maximum children’s daily dosage is 1000 mg.
A variety of side effects have been associated with carbamazepine. They include muscle or joint pain, abdominal pain, constipation, blurred vision, anemia, fainting, drowsiness, hair loss, headache, dizziness, hallucinations, impotence, itching, breathing problems, low blood pressure, sensitivity to light, and sweating. Side effects that include fever, sore throat, mouth ulcers, bruises, or reddish spots on the skin may indicate a blood disorder, which requires immediate medical treatment.
Patients with a sensitivity to certain antidepressant drugs (such as amitriptyline) or with reduced bone-marrow function should not use carbamazepine. It should be used with caution by patients with drug sensitivities and by those who have glaucoma, or impairment of heart, liver, or kidney function. Pregnant or nursing women should avoid using this drug. Because of the potential for dizziness or drowsiness, patients taking this drug should not drive, operate dangerous machinery, or engage in other risk-related activities. Patients who take carbamazepine to control seizures should not stop taking it abruptly, as severe, continuous seizures may result.
Carbamazepine should not be combined with antidepressants known as MAO inhibitors. It may also interact adversely with lithium, theophylline, doxycycline, haloperidol, as well as calcium channel blockers, oral contraceptives (see Birth Control Pill), and other antiseizure medications.
Divalproex
Divalproex, also known as valproic acid, drug used to treat seizures, such as those associated with epilepsy. It is also sometimes used to treat migraine headaches. Divalproex works by increasing the availability of certain chemicals needed for nerve transmission, suppressing the abnormal electrical discharges that cause seizures.
Available in tablet form, this drug is prescribed in amounts based on body weight. The typical starting dose is 15 mg per kg (2.2 lb), which is increased as needed (to a maximum of 60 mg per kg) to control symptoms. The usual daily dosage ranges from 1000 to 1600 mg, which is divided into several smaller doses. The drug should be taken one hour before a meal but may be taken with food to avoid stomach upset. Effectiveness in controlling seizures is usually seen within two weeks of treatment.
Patients with impaired liver function or a bleeding disorder should not take divalproex. This drug can cause liver damage, especially when used in children under the age of two. (Symptoms of liver impairment may include dizziness, drowsiness, facial swelling, muscle weakness, loss of appetite, vomiting, yellowing skin or eyes, and loss of seizure control.) Pregnant or nursing women should not use this drug. Divalproex should not be stopped abruptly, as continuous seizures may result. This drug slows blood clotting, which may result in excessive bleeding during injury, surgery, or dental procedures.
Possible side effects include indigestion, nausea, and vomiting. Some patients experience drowsiness and, as a result, should not drive, operate dangerous machinery, or engage in other risk-related activities. Other possible side effects include abdominal cramps, fever, double vision, constipation, behavior changes, itching, fluid retention, skin rash, tremors, or weight gain.
Divalproex may interact adversely with aspirin, antihistamines, sleep aids, tranquilizers, blood thinners, and birth control pills. It also may interact with erythromycin, isoniazid, and other seizure medications, such as carbamazepine and phenytoin. Divalproex should not be combined with alcohol.
2.Anti-Depressants
Amitriptyline
Amitriptyline, an antidepressantdrug. Typically used to treat mental depression, amitriptyline may also be used to treat chronic pain, bulimia, migraine headaches, and certain symptoms of multiple sclerosis. It works by restoring levels of neurotransmitters, chemicals in the brain that help transmit nerve impulses.
Amitriptyline is available only by prescription. It is taken orally in tablet form, often once a day at bedtime. Dosages generally begin at 50 or 75 mg and are then gradually increased to 150 or 200 mg, the maximum daily dosage for adults. Children over age 12 generally take about 30 mg per day. Children under age 12 should not take this drug. Benefits from amitriptyline may not be seen for several weeks after first starting the medication.
Patients recovering from a heart attack should not take this drug, nor should people who are taking monoamine oxidase inhibitors such as phenelzine, another type of antidepressant. Its safety for use during pregnancy has not been adequately studied, but it is known to appear in breast milk. Patients with certain medical conditions should avoid using amitriptyline unless advised by a doctor; these include seizures, heart or circulatory disorders, liver ailments, and eye disorders such as glaucoma. In addition, patients undergoing medical or dental procedures should be aware that amitriptyline can react adversely with anesthetics and other drugs used during these procedures.
Possible side effects of amitriptyline include a wide variety of ailments, including dry mouth, dizziness, drowsiness, blurred vision, breast enlargement, headache, disorientation, diarrhea, constipation, vomiting, fatigue, anxiety, high fever, heart attack, impotence, insomnia, seizures, or stroke. This drug may also increase the skin’s sensitivity to sunlight. These side effects are more likely to appear when the drug is first used and usually disappear after a few days. Lowering the dosage or eliminating the drug can produce side effects as well; these may include headache, nausea, irritability, or sleep disturbances. An overdose of amitriptyline can be fatal.
This drug may interact adversely with a broad variety of drugs, including but not limited to allergy and cold medications, barbiturates, antihistamines, tranquilizers, muscle relaxants, oral contraceptives, painkillers, seizure medications, sleep medications, thyroid hormones, and large doses of vitamin C. It should not be combined with alcohol.
3.Atenolol
4.Caffine
5. Ca Chnnel Blocker
Verapamil
&
6. Vasoconstrictor
Migraine, severe headache that occurs periodically and is sometimes confined to only one side of the head. A migraine is characterized by intense, throbbing, often blinding pain, and one or more of the following symptoms: sensitivity to light, nausea, vomiting, chills, facial swelling, tenderness of the scalp, sweating, frequent urination, irritability, visual hallucinations, and malaise. The headache may be preceded by a warning sensation, known as an aura, that may include flashes or patterns before the eyes,
illusory tastes or odors, dizziness, tingling, or numbness.
More than 26 million people in the United States suffer from migraines, which can last for hours or days at a time and recur at intervals ranging from one day to several years. Women are twice as likely as men to experience these headaches, and some evidence suggests that migraines are inherited. They tend to affect people for the first time between the ages of 10 and 30; symptoms tend to become far less intense after the age of 50.
At the onset of a migraine headache, blood vessels within the head constrict, causing a decrease in blood flow to the surface of the brain. Swelling of blood vessels in the head and scalp then sets off a chain of reactions that result in the headache. Among the biochemical changes associated with migraines are a reduced level of the neurotransmitter serotonin as well as an insufficient supply of enkephalins, the brain’s pain-relieving chemicals.
Hormonal level changes (such as those experienced by women during menopause or menstruation), endocrine imbalances, and stress due to anything from overwork to loud noises are considered precipitating factors of migraine headaches in susceptible people. Other factors that may trigger attacks include allergies, excess carbohydrates in the diet, foods rich in the trace element iodine, and alcoholic beverages.
Treatment
Several treatments have been successful in helping migraine sufferers. These include medications such as sumatriptan and ergotamine tartrate, both of which shrink swollen blood vessels, thereby aborting the acute phase of a migraine attack; and propranolol, which stabilizes blood vessel tone and helps prevent subsequent attacks. Other drugs often prescribed to migraine sufferers are amitriptyline, phenelzine, and verapamil. Biofeedback techniques have also proven useful.
1.Anti Convulsants
Carbamazepine
Carbamazepine or Tegretol, prescription drug used to treat seizures such as those associated with epilepsy. It also relieves neuralgia, or pain along a sensory nerve, in the jaw, tongue, or throat. The drug is occasionally prescribed for patients recovering from alcohol or cocaine addiction, for migraine headaches, and for depression or other emotional disorders. It works by suppressing impulses along nerve fibers in the brain, making seizures less frequent and less severe. It also prevents the transmission of certain nerve impulses, thereby reducing pain.
Carbamazepine is taken orally and is available in tablet form, usually taken twice a day, or liquid form, usually taken four times a day. Both forms should be taken with meals. Daily dosages for control of seizures range from 800 to 1200 mg, the higher recommended dose for adults and children over the age of 12. For neuralgia, doses of 400 to 800 mg per day are usually effective. The drug is typically prescribed in small doses in the beginning, which are increased daily or weekly until symptoms are relieved. This process may take three months or more. Children six years and older may take this drug, although it is usually prescribed in smaller amounts. The maximum children’s daily dosage is 1000 mg.
A variety of side effects have been associated with carbamazepine. They include muscle or joint pain, abdominal pain, constipation, blurred vision, anemia, fainting, drowsiness, hair loss, headache, dizziness, hallucinations, impotence, itching, breathing problems, low blood pressure, sensitivity to light, and sweating. Side effects that include fever, sore throat, mouth ulcers, bruises, or reddish spots on the skin may indicate a blood disorder, which requires immediate medical treatment.
Patients with a sensitivity to certain antidepressant drugs (such as amitriptyline) or with reduced bone-marrow function should not use carbamazepine. It should be used with caution by patients with drug sensitivities and by those who have glaucoma, or impairment of heart, liver, or kidney function. Pregnant or nursing women should avoid using this drug. Because of the potential for dizziness or drowsiness, patients taking this drug should not drive, operate dangerous machinery, or engage in other risk-related activities. Patients who take carbamazepine to control seizures should not stop taking it abruptly, as severe, continuous seizures may result.
Carbamazepine should not be combined with antidepressants known as MAO inhibitors. It may also interact adversely with lithium, theophylline, doxycycline, haloperidol, as well as calcium channel blockers, oral contraceptives (see Birth Control Pill), and other antiseizure medications.
Divalproex
Divalproex, also known as valproic acid, drug used to treat seizures, such as those associated with epilepsy. It is also sometimes used to treat migraine headaches. Divalproex works by increasing the availability of certain chemicals needed for nerve transmission, suppressing the abnormal electrical discharges that cause seizures.
Available in tablet form, this drug is prescribed in amounts based on body weight. The typical starting dose is 15 mg per kg (2.2 lb), which is increased as needed (to a maximum of 60 mg per kg) to control symptoms. The usual daily dosage ranges from 1000 to 1600 mg, which is divided into several smaller doses. The drug should be taken one hour before a meal but may be taken with food to avoid stomach upset. Effectiveness in controlling seizures is usually seen within two weeks of treatment.
Patients with impaired liver function or a bleeding disorder should not take divalproex. This drug can cause liver damage, especially when used in children under the age of two. (Symptoms of liver impairment may include dizziness, drowsiness, facial swelling, muscle weakness, loss of appetite, vomiting, yellowing skin or eyes, and loss of seizure control.) Pregnant or nursing women should not use this drug. Divalproex should not be stopped abruptly, as continuous seizures may result. This drug slows blood clotting, which may result in excessive bleeding during injury, surgery, or dental procedures.
Possible side effects include indigestion, nausea, and vomiting. Some patients experience drowsiness and, as a result, should not drive, operate dangerous machinery, or engage in other risk-related activities. Other possible side effects include abdominal cramps, fever, double vision, constipation, behavior changes, itching, fluid retention, skin rash, tremors, or weight gain.
Divalproex may interact adversely with aspirin, antihistamines, sleep aids, tranquilizers, blood thinners, and birth control pills. It also may interact with erythromycin, isoniazid, and other seizure medications, such as carbamazepine and phenytoin. Divalproex should not be combined with alcohol.
2.Anti-Depressants
Amitriptyline
Amitriptyline, an antidepressantdrug. Typically used to treat mental depression, amitriptyline may also be used to treat chronic pain, bulimia, migraine headaches, and certain symptoms of multiple sclerosis. It works by restoring levels of neurotransmitters, chemicals in the brain that help transmit nerve impulses.
Amitriptyline is available only by prescription. It is taken orally in tablet form, often once a day at bedtime. Dosages generally begin at 50 or 75 mg and are then gradually increased to 150 or 200 mg, the maximum daily dosage for adults. Children over age 12 generally take about 30 mg per day. Children under age 12 should not take this drug. Benefits from amitriptyline may not be seen for several weeks after first starting the medication.
Patients recovering from a heart attack should not take this drug, nor should people who are taking monoamine oxidase inhibitors such as phenelzine, another type of antidepressant. Its safety for use during pregnancy has not been adequately studied, but it is known to appear in breast milk. Patients with certain medical conditions should avoid using amitriptyline unless advised by a doctor; these include seizures, heart or circulatory disorders, liver ailments, and eye disorders such as glaucoma. In addition, patients undergoing medical or dental procedures should be aware that amitriptyline can react adversely with anesthetics and other drugs used during these procedures.
Possible side effects of amitriptyline include a wide variety of ailments, including dry mouth, dizziness, drowsiness, blurred vision, breast enlargement, headache, disorientation, diarrhea, constipation, vomiting, fatigue, anxiety, high fever, heart attack, impotence, insomnia, seizures, or stroke. This drug may also increase the skin’s sensitivity to sunlight. These side effects are more likely to appear when the drug is first used and usually disappear after a few days. Lowering the dosage or eliminating the drug can produce side effects as well; these may include headache, nausea, irritability, or sleep disturbances. An overdose of amitriptyline can be fatal.
This drug may interact adversely with a broad variety of drugs, including but not limited to allergy and cold medications, barbiturates, antihistamines, tranquilizers, muscle relaxants, oral contraceptives, painkillers, seizure medications, sleep medications, thyroid hormones, and large doses of vitamin C. It should not be combined with alcohol.
3.Atenolol
4.Caffine
5. Ca Chnnel Blocker
Verapamil
&
6. Vasoconstrictor
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