Migraine

A migraine is a moderate to severe headache described sometimes as a throbbing pain on one side of the head, which can last a few hours or even a few days. It effects around 1 in 5 women and around 1 in 15 men. In addition to the pain, many people also experience symptoms such as:

• Photophobia – Increased sensitivity to light
• Phonophobia – Increased sensitivity to sound
• Nausea and Vomiting

Some people may experience an aura before having their migraines in the form of flashing lights, blind spots and other visual disturbances.

It is very important to see your doctor (if you haven’t already) to discuss your headaches and confirm the diagnosis of migraine before self-treating. You should also discuss with your doctor prior to self-treating if any of the following apply:

• Your migraines/headaches have started for the first time over the age of 40
• If your headaches are becoming more frequent or changing in their presentation
• If your migraines are affecting your limbs and cause disability

CAUSES

The specific cause of migraines has not been fully established yet, however it is believed to be due to over release of chemicals in the brain and or dilation of specific blood vessels in the brain. Migraines can be triggered by external factors, so it is important to try and recognise what triggers your migraines and try to avoid those things. These can include:

• Stress
• Tiredness
• Lack of sleep
• Medications
• Foods such as chocolate
• Drinks such as those high in caffeine

TREATMENTS – TRIPTANS

Triptans are a group of drugs used to treat migraines that do not respond to or controlled by conventional over the counter pain killers. Sumatriptan (also known by the brand name Imigran) is the only triptan available over the counter without prescription. However it does not work for everyone and we can provide other triptan medications, if assessed as being suitable for you after completing our safety questionnaire. One of our prescribers will review your responses to our questionnaire and issue a prescription ready to be dispensed and shipped to you by our pharmacy team.  

Triptans work to stop migraines in two ways :

1. They cause pain causing blood vessels in the brain to constrict.
2. They reduce chemicals in the brain thought to be involved in migraines.

All the triptans work in the same way, however some work better for others with less side effects and a faster onset of action while others work for a more prolonged period of time. Some of the triptans are available as nasal sprays, which get to work more quickly, but are also ideal for those who have trouble swallowing tablets during a migraine due to nausea and vomiting. You can also get certain tablets in oro-dispersible (dissolve in the mouth) formulations to make it easier to take.

See the comparison table below

You should always start with the lowest possible dose and move to a higher dose if symptoms are not adequately controlled. If you find that your migraine is not relieved by the initial dose, it is not recommended to take any further doses for the same migraine attack.

Due to the nature of the tablets and how they work, they should not be taken by people who have had:-

• Strokes or Mini- Strokes
• Poor circulation (i.e Reynaud’s Syndrome)
• Cardiovascular disease (Angina)
• Heart attacks

Prior to starting any treatment, please read the Patient Information Leaflet CAREFULLY. The links to these can be found in the medical information section of each drug.