A Comprehensive Medicine approach to migraines

Townsend Letter for Doctors and Patients, Jan, 2005 by Jacob Teitelbaum

A fascinating study can guide you as to when to use Imitrex family medications vs. when to go with other therapies. At last year's American Academy of Neurology meeting, Dr. Burstein of Harvard Medical School noted that 75% of migraine patients get painful sensitivity to normal touch (e.g. from eyeglasses) around their eyes. This pain is created in a different part of the brain than the throbbing pain that gets worse with movement or coughing. The study found that if you use Imitrex before you get the tenderness/pain around the eyes, it will knock out the migraine 93% of the time. If the pain/tenderness around the eyes had already set in, Imitrex only eliminated the migraine 13% of the time (although it still helped the throbbing). In other words, if you are one of the lucky ones who does not get pain around the eyes, the Imitrex can knock out your migraine at any time. If you are one of those who get pain/tenderness around the eyes, it is a race against the clock to take the Imitrex before that pain starts. This means, take the Imitrex early in the attack (within the first 5 to 20 minutes) before the skin hypersensitivity gets established. For example, use it at the earliest warning signs like painful scalp or discomfort from wearing your glasses, shaving or wearing earrings. If the pain has already fully set in before you take the Imitrex, consider using one of the other acute treatments we've discussed. (12)

Because of the nausea and light/sound sensitivity, anti-nausea medications can also be helpful. Phenergan[R] or Compazine[R] suppositories are two such medications.

What Natural Remedies Can I Use to Knock Out an Acute Migraine?

Two natural treatments can knock out an acute migraine. The first, which you can take at home on your own, is butterbur. This herb can both prevent and eliminate migraines. Take 50 mg 3 times a day for 1 month and then 50 mg twice a day to prevent migraines. You can take 100 mg every 3 hours to eliminate an acute migraine. Use only high quality brands (e.g.-Integrative Therapeutics). Many others that were tested had impurities and did not contain the amount of butterbur the label claimed (i.e. they don't work).

In a hospital emergency room or a doctor's office, intravenous magnesium can effectively eliminate an acute migraine. In one study of 30 patients with moderate or severe migraine attacks, half received 1 g of magnesium sulfate IV over 15 minutes and the other half placebo. Those in the placebo group who were not better by a half-hour were then treated with the magnesium. Immediately after treatment, at 30 minutes, and at 2 hours, 86% in the magnesium group were pain-free with the other 14% showing a reduction in pain. Associated symptoms such as nausea, light sensitivity, and irritability also resolved, and none of the patients in the magnesium group had a recurrence of pain within 24 hours. In the placebo group, no patient became pain free, and only one had a reduction in pain. When patients in the placebo group were later given the magnesium, responses were similar to subjects in the other magnesium treated group. Mild side effects, which are a normal effect of magnesium working to open blood vessels, such as a burning sensation in the face and neck, flushing, and a drop in blood pressure of 5 to 10 mm systolic occurred in 86% of the patients. None of these side effects was serious, and no patient had to discontinue the treatment. (13) These results were similar to those in previous reports. (14,15)