How to Prevent Migraines

There are several kinds of remedies you can try to stop those awful migraine headaches before they start. Here's how to prevent migraines, maybe for good. 

The usual migraine treatment

A migraine — the throbbing, often nauseating headache that sometimes comes with an aura — interferes with your life in a big way. The pain can disable you for as long as three days. Preventing these attacks is a much better idea than only trying to treat the pain. Once a migraine has flared up, you can take ibuprofen or Excedrin Migraine, which contains acetaminophen, aspirin, and caffeine. You may also have a prescription for sumatripan, rizatriptan, or almotriptan. However, these remedies may not work and leave you feeling exhausted. Also, if you take them too often, you could end up getting more headaches.   

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Other drugs are designed to prevent migraines. However, they help only about half of all patients and not entirely — you might get about half as many migraines.

But there are several other remedies you can try to prevent migraines. Talk to your doctor about identifying your triggers, trying out an electric stimulator, working with a therapist and treating anxiety or depression, taking supplements, or receiving Botox shots.

How to prevent migraines

Learn your triggers. Some people react to a specific food, often alcohol or bacon, or to monosodium glutamate. Others react to bright lights, certain strong smells, or strong emotions. Stay away from any triggers you suspect, such as alcohol, caffeine, stress, or poor sleep.

Electrical stimulation. The Food and Drug Administration (FDA) has approved a device called “Cefaly” — a battery-powered headband with an electrode — that stimulates branches of the trigeminal nerve in your face and head. Migraines, in the most current theory, arise when blood vessels in the brain expand and become inflamed in response to that nerve. Users must wear the headband and turn it on for 20 minutes a day.

People with pacemakers or implanted defibrillators shouldn’t try this. 

A December, 2015 study found that Cefaly was most effective in patients who get frequent migraines, and on average cut use of drugs to treat a migraine by 37 percent. In another study, more than half the people who tried the device for nearly 60 days decided they were satisfied enough to buy it. People who didn’t use the device as often as prescribed tended to be dissatisfied. Many migraine sufferers also say that using Cefaly during an attack can help make it less painful or end earlier and some early research backs them up.

A unit costs about $350 and comes with a 60-day guarantee, so you can try it for yourself.

Relaxation and cognitive behavioral therapy. Learning a relaxation practice and also techniques from cognitive behavioral therapy — managing your anxious or depressed thoughts —  have together given migraine sufferers some relief, studies suggest. What you think about your pain is important, researchers have found — if you believe it is a punishment, for example, your emotions will aggravate the pain. Most people are sensitive to light during a migraine, but some sufferers are sensitive to bright lights all the time. They are more likely to be fighting high anxiety or depression, research suggests. If that’s you, don’t put off seeing a psychiatrist or therapist for advice. The remedies include medication, therapy, exercise, and diet — and even if you’ve lost hope, the truth is you can feel better.  

Supplements. Mark W. Green, MD, a professor of neurology, anesthesiology, and rehabilitation medicine at Mount Sinai in New York, and the co-author of Managing Your Headaches, has seen supplements help some people who also try one of the other approaches. Taking 400 mg a day of the B vitamin riboflavin can make migraines less frequent. People who are low in magnesium can benefit from taking 500 mg a day. But check with your doctor, since the supplements can interact with other medications.

Botox. In 2010, the FDA approved using Botox injections to treat chronic migraines. The shots may turn off pain receptors. A headache specialist — not someone who gives Botox for cosmetic reasons — will inject the drug in your scalp and neck in about 15 minutes. You’ll have to come back in three months for another treatment.  Green advises his patients to commit to three treatments — over 9 months — before they decide whether to continue.

Although the shots are only mildly painful, the side effects of botox can include temporarily blurred vision and speech. If you have recurrent severe migraines, the shots may be covered by health insurance.

Don’t just endure through migraines. Keep looking for solutions and you may find significant relief. 

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