Migraine Prevention: Approaching a doctor

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​The education above is made possible by a grant from Lundbeck.

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Migraine Expedition

Meet Mary. She was recently diagnosed with migraine. Watch this animated short to learn important details that come along with a migraine diagnosis. 

Migraine Expedition: Managing migraine is just like preparing for an expedition. You and your healthcare provider will fill your backpack with tools so you can be prepared to enjoy your journey. Download your Migraine Expedition Map. Continue below. 

​Survey Results

​Below are the non-identifiable results of the Patient Mind Inc. community. If you haven't already, please take the survey to see where you stand with your Migraines.

Linda (Headache Specialist)

Dr. Linda is a Neurologist who specializes in migraine. She will be your guide in preparing for your migraine expedition. Below is a checklist of tools you will need to prepare for your journey in managing migraine.  

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​Treatment Options (PREVENTION)
​Prevention (Taken on a regular basis to prevent migraine, whether you have a headache or not).​ Click/Tap to expand each type.

MABs (CGRP Monoclonal Antibodies)

• Monoclonal Antibodies (MABs): Triggers elevate levels of CGRP in certain parts of the brain, which cause inflammatory events. CGRP is involved in the transmission of pain when it binds to CGRP receptors. ​
  • MAB: Eptinezumab
    • Delivery: IV Every Three Months
    • Brand Name: Vyepti
    • Website: https://www.vyepti.com/
    • Made by: Lundbeck
    • For Episodic or Chronic Migraine: Must have tried a previous prevention option.
  • MAB: Fremanezumab-vfrm
    • Delivery: Self-Administered Quarterly or Monthly Injection
    • Brand Name: Ajovy
    • Website: https://www.ajovy.com
    • Made by: Teva
    • How it works: Binds to CGRP Blocking Pain Signals
    • For Episodic or Chronic Migraine: Must have tried a previous prevention option.
  • MAB: Erenumab-aooe
    • Delivery: Self-Administered Monthly Injection
    • Brand Name: Aimovig
    • Website: https://www.aimovig.com/
    • Made by: Amgen and Novartis
    • How it works: Binds to CGRP Receptor Blocking Pain Signals.
    • For Episodic or Chronic Migraine: Must have tried a previous prevention option.
  • MAB: Galcanezumab-gnlm
    • Delivery: Self-Administered Monthly Injection
    • Brand Name: Emgality
    • Website: https://www.emgality.com/
    • Made by: Lilly
    • How it works: Binds to CGRP Blocking Pain Signals
    • For Episodic or Chronic Migraine: Must have tried a previous prevention option.

OnabotulinumtoxinA (BOTOX)

​OnabotulinumtoxinA (FDA Approved in 2010)

• ​Delivery: 31 injections every 3-months by Healthcare Provider
• Brand Name: BOTOX
• Website: https://www.botoxchronicmigraine.com/
• Made by: Allergan
• How it works: Blocks Pain Signals
• Must be diagnosed with Chronic Migraine (15+ Headache Days Per Month)

Blood Pressure Meds

• ​Beta Blockers
  • ​Propranolol/Inderal (Brand)
  • Timolol/Blocadren (Brand)
  • Metoprolol/Toprol (Brand)
  • Nadolol/Corgard (Brand)
• Calcium Channels Blockers
  • Verapamil/Calan, Isoptin (Brands)
• ARB (Angiotensin Receptor Blocker)
  • Candesartan/Atacand (Brand)

Antidepressants

• ​Tricyclic Antidepressants
  • ​Amitriptyline/Elavil (Brand)
  • Nortriptyline/Pamelor (Brand)
• SNRI (Serotonin and Norepinephrine Reuptake Inhibitor)
  • ​Venlafaxine/Effexor (Brand)

Seizure Meds

• Topiramate/Topamax, Trokendi, Qudexy (Brands)
• Valproate/Convulex, Depakote, Epilim, Stavzor (Brands)

Michael (Headache Specialist)

Dr. Michael is a Neurologist who specializes in migraine. Below is a checklist of preventive tools you may need to prepare for your journey in managing migraine. Prevention treatments are taken on a regular basis to prevent or reduce the number of headache days you have per month. ​

​Find a Headache Specialist in Your Area

​​Treatment Options (ACUTE)

• Acute Treatment (Taken when a migraine begins).​ Click/Tap to expand each type.

NSAIDs

• Ibuprofen/Advil, Motrin (Brands)
• Naproxen Sodium/Aleve, Anaprox (Brands)
• Diclofenac Potassium/Cambia (Brand)
• Ketorolac/Toradol (Brand)

          *NSAIDs stands for NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

Triptans

• Almotriptan/Axert (Brand)
  
• Eletriptan/Relpax (Brand)
  
• Frovatriptan/Frova (Brand)
  
• Naratriptan/Amerge (Brand)
  
• Rizatriptan/Maxalt (Brand)
• Sumatriptan/Imitrex, Zembrace, Onzetra, Tosymra (Brands)
• Zolmitriptan/Zomig (Brand)

Combinations

• Naproxen + Sumatriptan/Treximet (Brand)
• Aspirin + Acetaminophen + Caffeine/Excedrin Migraine, Goody's, BC Powder (Brands)

Ergots

• Dihydroergotamine/Migranol (Brand)
  
• Ergotamine/Ergomar (Brand)

Nausea Meds

• Prochlorperazine/Compazine, Compro (Brand)
• Metoclopramide/Reglan (Brand)

Lasmiditan

Lasmiditan (Reyvow) is a new option for the acute treatment of migraine.

• Reyvow is a oral treatment that binds to receptors to treat acute treatment of migraine, with or without aura, in adults.
  
• The precise mechanism is unknown. 
• Reference: https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-patients-migraine

Ubrogepant

• ​Ubrogepant (Ubrelvy) is an oral, small-molecule calcitonin gene–related peptide receptor antagonist for acute migraine treatment.
• https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-adults-migraine
  

Devices

There are several devices that are FDA approved for the acute treatment of migraine. More information coming soon.

Kim (Headache Specialist)

Dr. Kim is a Neurologist who specializes in migraine. Below is a checklist of acute tools you may need to prepare for your journey in managing migraine. Acute medications are taken when a headache happens to reduce the pain. ​​

​Find a Headache Specialist in Your Area

​​Lifestyle

• Healthy lifestyle techniques truly help those with migraine.​ Click/Tap to expand each type.

Manage Migraine Triggers

Triggers include stress, light, noise, odors, weather, diet, and hormonal changes.

• Stress management may include exercise, relaxation, and positive thinking.
• Light management may include sunglasses or avoiding light.
• Wear ear protection or minimize noise.
• Learn and avoid odors that trigger your migraines.
• Be prepared for weather changes with your complete expedition list.
• Don't eat foods or drink things that you know cause your migraines.
• Form a plan with your healthcare provider if you have menstrual migraine.

3 Healthy Meals + Healthy Snacks

• A healthy diet may include eating natural foods that are not processed and low in sugar.
• Be prepared with healthy snacks to avoid long periods of hunger.

72 oz. of Water Per Day

Drink water and avoid too much caffeine, artificial sweeteners, and sugar. 

Regular SleeP

• Practice a regular sleep schedule.
• Sleep in a comfortable space free from distractions.

Exercise + Yoga Daily

• Get some kind of enjoyable physical activity every day.
• Learn and practice basic yoga.

Relaxation and Deep Breathing

• Make time to relax every day free from distraction.
• Focus on breathing in for 3 seconds, hold for 1 second, and exhale for a count of three. Repeat until relaxed.

Track Your Migraines Daily

• Track your migraines daily.
• Document what you did right on the days without headache.
• Document triggers or what you think you did wrong on the days with headache.
• Take this detailed documentation in to your next clinical visit. 
• Try to find a pattern of the positive and negative. 
• Adjust your migraine treatment plan accordingly. 

Advice from a Headache Specialist

Below is a healthy lifestyle checklist. If you follow these eight practices, they will greatly help you reduce the number of headaches you have per month. 

​Find a Headache Specialist in Your Area

Patient Migraine Hero Cards

• Check out Jada's migraine stats below. Click/Tap to expand each topic. These will help you relate and learn how a migraine management plan will reduce migraine frequency.

History

Jada had a couple migraines in her teens, and she remembers her mom suffering from headaches, however her mom never got diagnosed with migraine. When Jada started college in 2014, she started averaging about 4 headache days per month. She went to her healthcare provider and was diagnosed with migraine.

Talent

Jada is very talented in the creative arts. Her favorite things to do are to draw and paint portraits of people. But, as her migraines became more frequent, her interests were lost and she started to get depressed. 

Preventive Meds

Jada's meticulously tracked her headache days so her healthcare provider would realize the impact the migraines were having on her life. She was prescribed an antidepressant, which can be used to  prevent migraine... plus she was feeling depressed. Over the next year she struggled with the antidepressant and also tried a seizure medication which is another preventive option for migraine. She became frustrated. In late 2018 her provider told her about a new preventive medication called MABs. It did not work right away, however, now on average she is having 12 less headache days than her worst year and a 50% reduction in frequency. 

Acute Meds

Jada was prescribed acute medications, which are medications you take at the first sign of headache pain. She tried eletriptan, naratripan, and excedrin over the years. Jada and her provider adjusted her plan to ibuprofen or sumatriptan. She decided on sumatriptan because it is available in a shot or powder form. This helps because sometimes Jada gets nausea with her migraine, so she wanted something that would bypass her stomach and that would work faster.

Exercise

Jada enjoys walking and yoga daily. Occasionally she attends a dance class. Because Jada enjoys these exercises, she is more likely to continue. For example, Jada used to jog. She doesn't like to run so she found herself not exercising on a regular basis. Now with walking and yoga, she feels better physically and mentally. 

Relaxation

Jada learned to practice biofeedback. This is where she learn to control an automatic body function. For example, when Jada get's nervous her heart starts to race. By a combination of controlled deep breathing and imagery she can slow her heart rate. 

Sleep

When Jada started college her sleep schedule really suffered. She noticed the lack of sleep and the irregular sleep hour increased her migraine frequency. Now she practices a regular sleep schedule from 11pm to 7am.

Diet

Stages

Triggers

Tracking

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