In addition to conventional headache remedies, there are also medications on the market that can prevent migraine attacks and treat migraines in general. For the most common products, we list the effects and disadvantages of the medicine.
Anti-inflammatories
Anti-inflammatories are not normally used for headaches, but some migraine patients may benefit from them.
Operation
Anti-inflammatory drugs inhibit the production of prostaglandins that are involved in inflammatory processes such as swelling and the permeability of the capillaries. It is believed that components related to the inflammatory prostaglandins are responsible for the migraine changes in the blood vessels.
Brand names
- Rociclyn – tolfenamic acid
Disadvantages
Frequent use can lead to heartburn and damage to the stomach lining.
Serotonin agonists
Serotonin agonists are used to interrupt a migraine attack.
Operation
They promote the action of serotonin (a neurotransmitter also called 5-hydroxytrytamine-1) on the vessel walls and in the brain. This causes narrowing of the blood vessels and stimulates clotting. It relieves the painful vasodilation of migraines.
Brand names
- Sumatriptan – also known as Imigran
- Naramig (naratriptan), Maxalt (rizatriptan), Zomig (zolmitriptan) are new variants of this preparation.
Disadvantages
Serotonin agonists can reduce blood flow to the heart muscle and increase blood pressure. They may cause a feeling of drowsiness at the beginning of treatment.
Ergot alkaloids (ergotamine, dihydroergotamine)
These chemicals are derived from a fungus that grows on moist rye and has a very colorful history. In the Middle Ages, this fungus was thought to be responsible for visions and devilish properties, while today it is blamed for the rise of hallucinogenic drugs. Ergot alkaloids are used to suppress a migraine attack.
Operation
Ergotamine causes immediate and extreme vasoconstriction of the extra-cerebral arteries.
Brand names
- Migril – ergotamine
- Cafergot – ergotamine, caffeine
- Ercycopherergotamine, caffeine, cyclizine
- Dihydergot – dihydroergotamine
Disadvantages
Due to the extreme vasoconstriction caused by this medicine, oxygen deficiency can occur in tissues. In the worst case, necrosis (death of tissue) and gangrene can occur. Ischemia and irritation of the digestive tract as well as a disruption of the regulatory function of the vagus nerve (wandering nerve) can lead to diarrhea and vomiting.
Serotonin antagonists and antihistamines
These drugs are used prophylactically, which means they are used to prevent a migraine attack.
Operation
They prevent the vasodilator effect that histamine has and the vasoconstrictor effect that is attributed to serotonin.
Brand names
- Sandomigran – pizotiphene
Disadvantages
They cause drowsiness, dry mouth and stimulate appetite, which promotes weight gain. They also reduce muscle response, which can lead to clumsy behavior.
Beta blockers
Operation
Beta-blockers (or beta-blockers) block beta receptors, so that vasoconstrictor stimuli from the sympathetic nervous system can no longer be transmitted.
Disadvantages
Beta blockers can cause a narrowing of the bronchi, possibly causing asthmatic symptoms. Fatigue, cold extremities, decreased blood pressure and heart rate are also commonly reported.
Antidepressants
Operation
Some antidepressants prevent the breakdown of serotonin. This stimulates vasoconstriction of the cerebral blood vessels.
Brand names
- Triptizol – amitriptyline
- Sarotex-amitriptyline
- Anafranil – clominpramine
- Sinequan – doxepin
- Tofranil – imipramine
Disadvantages
When antidepressants are taken during the day, side effects such as dry mouth or drowsiness may occur.
Please note: always consult the product leaflet before use
Other medicines to relieve migraines
Because of their serious side effects, clonidine, methysergide, and sodium valproate should only be used under medical supervision. They are administered for their vasoconstrictor and sedative effect.
In addition to the direct-acting drugs mentioned above, doctors may prescribe the contraceptive pill or HVT (hormone replacement therapy) to induce a change in women’s hormone levels. For some women this can provide relief from migraines.
