Our expert says:
B, migraine prophylaxis is a tricky thing. There is no treatment that is guaranteed to work. The important thing about migraine is to try and prevent the thing from happening. Try to identify the triggering factors (see above) which cause your migraine, by studying the pattern of events before an attack. By keeping a dairy in which you note changes in routine, food and drink etc. and eliminating the triggering factor, you can prevent a migraine attack or at least eliminate the need for prophylactic treatment. Try to eat regular meals, as low blood sugar can also trigger an attack. If you don’t have the time, drink a Coca-Cola (wonderful stuff, tastes great and has medicinal value). If you suffer from two or more attacks per month, your friendly neighbourhood GP should prescribe a preventative medicine to be taken daily for a period of time. Methysergide (Deseril®) is effective but can cause eye, lung and heart damage if taken for longer than three months. Clonidine (Dixarit®) and Pizotifen (Sandomigran®) have also been used with success. All three of them are not safe to be taken during pregnancy and breast feeding. Propranolol 20 to 40mg, 3 to 4 times a day, offers long-term relief in half of patients. Unfortunately the whole prophylaxis thing is a matter or trial and error. This applies to the elimination of trigger factors as well as the prophylactic drug of choice. The good news though, is that migraine is not dangerous, just very unpleasant. You just have to be sure that it is migraine, otherwise a visit to your friendly neighbourhood GP should be on the cards.
The trigger factors have been identified include the following:
Certain foods, especially coffee, chocolate, nuts, dairy products, red wine, fried foods, shellfish, citrus fruits, spicy foods, cured or processed meats, peanuts and yeast.
Emotional and physical stress. This includes anger, anxiety, depression, and excitement.
Lack or excess of sleep.
Bright or flashing lights.
Good luck and let me know if you have more questions (just post them as a new question to ensure that I get them).
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