MEDICATION

When to use medication?

Regardless of which medication you use, it is of critical importance that you treat a migraine as soon as you know it is a migraine. Recent
research on migraine pain mechanisms has shown that if the pain is not treated in the mild-to-moderate phase, the medications we
currently have will be less effective. Sometimes, for whatever reason, there is a tendency for migraine sufferers to wait. For some people,
it is because they can't get enough medication. For others, it is just that they think something else will work, like a cup of coffee or eating.
Some neurologists think that poor judgment may be an early symptom of the migraine itself, and you may not be thinking clearly enough
to do the obvious and logical thing: take the medication that you know will work.

By waiting until the pain is throbbing and severe, migraine-specific medications will only reduce pain by about 40%, and change it from
throbbing to dull. At that point in the headache, adding a nonsteroidal anti-inflammatory can be helpful in further alleviating the pain.

If you experience nausea early in the headache, you should ask your physician for nausea medication or for a non-tablet type of migraine
medication. Several of the migraine-specific medications come in orally-dissolving forms for mild nausea, or nasal or injectable forms
for more severe nausea or vomiting.

About 50% of migraine attacks occur between 5:00 am and 9:00 am . Unless you are a very early riser, this may result in what is called
Early Morning Migraine, which means that it awakens you from sleep with a fully established migraine. When this happens, it is already
impossible to treat early as we discussed above. One of the things that happens in a migraine in most people is that the stomach slows
down. This makes it difficult, if not impossible, for you to absorb any medication that you swallow. Even if you are not experiencing
nausea, you may still have slowing of the stomach (called gastroparesis). Since pills are actually absorbed from the upper part of the
small intestine, and not the stomach itself, this is a problem. Therefore, if you have this sort of migraine, you might respond better to a
non-pill form of migraine-specific medication. The orally-disintegrating medications are still orally absorbed, and may not work fast
enough in this situation. The very fastest route to relief is injectable medication; nasal medications are almost, but not quite, as fast.