Katie, a 20-year-old college student, has suffered from migraines for several years. While Katie’s doctor recently prescribed her a new medication for migraine relief, Katie is worried about the possible side effects associated with migraine medications, including unknown long-term effects. Katie also worries about how she will afford her new medications.
Are you, like Katie, concerned about the potential for problems following long-term migraine medication usage? If so, you are not alone. One study published in the journal Headache found that two out of three individuals with recurring migraines delayed or avoided taking migraine medications due to concerns about treatment side effects.
The FDA has specifically approved three over-the-counter drugs (Excedrin Migraine, Advil Migraine and Motrin Migraine) and two prescription drug classes (Triptans and ergotamine) for treating migraine attacks. While other types of drugs, such as barbiturates and opioids, are sometimes prescribed for off-label attacks, these drugs have not been approved by the FDA and are also considered to be addictive. These drugs are not for “first-line” therapy, but should only be prescribed as a rescue treatment when all other options fail, due in part to the addictive nature of these drugs.
From the first flash of a migraine aura to the pulsating pain, nausea and sensitivity to lights and smells, a migraine attack is a serious and incredibly painful experience. While migraine drugs can bring relief to this debilitating pain, these drugs, like any medication, are not without their risks. Here’s what you need to know about the different migraine medications and the top migraine medications fears.
Migraine Medication Fear #1: Side Effects
All migraine medications, including FDA-approved over-the-counter treatments, may cause side effects, ranging from minor to potentially life-threatening. Minor side effects include nausea, dizziness, muscle cramps, chest pain, and abdominal pain. Migraine medications may also complicate blood circulation or cause persistent blood vessel contractions, which increases the risk for heart attack. Additionally, with certain medications, there is a risk for a life-threatening condition known as serotonin-syndrome. Some medications also increase the risk for kidney problems.
Migraine Medication Fear #2: Cost
Migraine medications are not inexpensive. Some patients worry that the price of migraine medications is simply more than they can afford, especially since these drugs need to be taken consistently in order to produce long-term health benefits and provide optimal migraine relief. However, failing to treat migraines can be just as expensive. From emergency visits to hospitalization, the cost of migraine relief treatments can quickly increase for patients that choose not to take regular medications.
Migraine Medication Fear #3: Inconsistent results
Could taking migraine medication actually increase headache intensity? The fear that migraine relief medication could actually lead to more pain is one concern shared by many migraine sufferers. These individuals worry that the migraine relief medications will become less effective as the body adjusts to a specific dosage. Consequently, patients will either need to up their medication strength or face more intense, longer-lasting headaches.
However, according to specialist Roger Cady, MD, sticking with migraine medication will ultimately reduce headache frequency and severity. While Cady warned that even the best migraine medications are only effective about half the time, once a doctor finds the right combination of migraine medications for a patient, the patient needs to stick with these drugs. In fact, Cady even says that patients may ultimately be able to safely come off these drugs once migraine medications have done their job: “Once the nervous system is back in control of things, patients can typically come off these medications.” While migraines increase in severity if patients do not follow the correct treatment protocol; by taking the right migraine relief medication, patients can ultimately decrease severity and may even be able to stop taking the medication all together.
Migraine Medication Fear #4: Long-term/unknown effects, including addiction/dependence.
If migraine pain is severe, doctors may prescribe opioid drugs such as morphine, codeine, meperidine (Demerol), and oxycodone (Oxycontin). Butorphanol is also an opioid in nasal spray form that may be prescribed as a migraine relief rescue treatment when other options fail. Opioids are not formally approved for migraine treatment and should never be used as first line therapy. Additionally, there is a risk for addiction with long-term use. Worse, these drugs may become ineffective with long-term use, as well. Doctors are advised not to prescribe these medications for individuals with a history of drug abuse problems or psychiatric disorders. While dependence and even addiction is possible with some opioid medications, the FDA-approved migraine medications are not addictive.
Read Understanding The Rebound Headache
Migraine Medications: Selecting the Right One
If you are considering new migraine medications, start by talking to your doctor about the right medication for your migraine relief needs. It is natural to be fearful about possible side effects and long-term health problems. However, by discussing things with your doctor and migraine support communities, you may discover that there are the right migraine medications for your needs. It is much better to follow a doctor’s prescription than to self-medicate for migraine relief.
Image Source: Gerry Dincher
http://www.nytimes.com/health/guides/disease/migraine/medications-for-treating-migraine-attacks.html http://www.ajmc.com/publications/supplement/2005/2005-06-vol11-n2suppl/Jun05-2069pS62-S67 http://www.webmd.com/migraines-headaches/news/20030116/migraine-drugs-effects-scare-many-away