Migraine and it’s Treatment

What is a migraine?

Migraines are a series of attacks which commonly progress through four phases. 

  1. The Prodrome. In the 24-48 hours before the onset of a headache most patients experience a prodrome phase which mostly involve non-specific symptoms such as yawning, neck stiffness, constipation, irritability, depression or even the opposite, euphoria. 
  2. The Aura. Some patient’s experience visual or auditory symptoms but others can experience an inability to speak normally or even inability to move muscles of their face properly. 
  3. The Headache. This is the cardinal symptom of a migraine and can be debilitating. The pain is often unilateral and is usually throbbing or pulsatile, especially as it increases in intensity. Patients usually have nausea and the pain is made worse by light. 
  4. The Postdrome. After the constant pain resolves, there is a period afterwards where sudden head movement causes an acute repeat of the pain. 

Signs to watch out for.

There are many different types of migraines and they can be confused with more sinister presentations so it is important to look out for “red flag” symptoms. 

These include;

  • ‘First’, ‘worst’ headache. If this is the first migraine or far worse than usual.
  • ‘Thunderclap’ headache. If the headache comes on instantaneously and is extremely painful. 
  • Headache in patients over 50 who haven’t had one previously. 
  • Headaches that that don’t respond to treatment.
  • Associated fever, stiff-neck or dramatic change in personality. 

Treatment

SeverityRecommended Treatment
Mild-Moderate
  1. Aspirin 900mg dissolved in water as soon as possible
    OR
  1. Ibuprofen 400mg orally
  1. If nauseua or pain isn’t resolving consider adding a combination of paracetamol 500mg and Metoclopramide 5mg

All of this treatment is available over the counter!

SevereIf there are any of the red flag symptoms evident, it is worth seeing a doctor for prescription medication or imaging!

Our Pharmacists also recommend non-pharmacological treatments such as;

  1. Cold packs over the forehead or back of skull 
  2. Heat packs over the neck or shoulder
  3. Neck stretches and self-mobilisation 
  4. Rest in a quiet, dark room

Migraines can be a significant cause of morbidity so if you think you or your family members are experiencing migraines come in and see the friendly team of pharmacists at Mooloolaba Beach Pharmacy!