Side Effects from Migraine Medications: Weighing Your Options

In lieu of natural alternatives, migraine sufferers use many forms of medications from over-the-counter drugs to prescription medicines. Each one comes with side effects and it is up to the patient to determine if the pros out-weigh the cons for their particular type of treatment.

Over-the-Counter Medications

There are a myriad of over-the-counter agents and some of them are specifically touted as being particularly effective for migraine; sometimes just for headache in general; sometimes for other types of headache, for example, tension-type headaches. Typically the most common over-the-counter medications are compounds that contain aspirin, acetaminophen and caffeine in varying doses. One example of this type is Excedrin. Products containing acetaminophen, like Excedrin or Tylenol, are highly unlikely to cause significant side effects or toxicities if used sensibly. If overused however, acetaminophen can cause significant liver damage, even liver failure and, less commonly, kidney problems, kidney damage, or kidney failure.

Another commonly used medication is ibuprofen which is one of a very large family of medications known as the nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is good for any kind of process that involves inflammation and can quite effectively suppress the inflammation, as can naproxen sodium (Aleve). There are, again, a myriad of different NSAIDs. None of them is particularly specific for migraine or for headache. Some have been more carefully tested as being acute migraine drugs and in some cases even preventative migraine drugs, but they can be quite useful actually in the treatment of migraines for many reasons.

As far as effectiveness for migraine headaches, it has been shown that Excedrin clearly is an effective medication for acute headache treatment, and it has been very well-tested in relatively well-controlled, large scale clinical trials, whereas, ibuprofen doesn’t have the same scientific basis as evidence. Not that it is ineffective; it may be more effective, but there haven’t been enough clinical trials to make that determination.

Medication overuse can cause trouble with the NSAIDs. They can cause inflammation of the stomach lining, gastritis, and even ulcer formation. They can aggravate esophageal reflux disease, gastroesophageal reflux disease, or GERD. They can cause anything from heartburn that is annoying but not dangerous to a perforated ulcer or a bleeding ulcer that is life threatening. So the NSAIDs have a potential for causing significant gastrointestinal toxicity. They also, used in high doses, have the potential for causing kidney damage and even liver damage.

Clearly, you have to use these over-the-counter medications with caution. There is good evidence that the so-called “medication overuse” headaches can happen with the combination drugs. They are combinations of acetaminophen, aspirin, and caffeine.

On a different note, doctors relate that sometimes patients make more out of the medications than what they really are. All the acetaminophen medications have relatively low dosages of the individual components so, in reality, a patient may be just as well off to take three aspirins and a Coke or take a generic brand of aspirin and a full cup of coffee instead of a half of cup of coffee instead of purchasing the medication over the counter.

Prescription Medications

Triptans

The triptans is a specific medication category that affects the serotonin, the 1B, 1D receptor at the synaptic level in the nervous system, and triptans will stop headache, migraine headache, but they won’t affect pain in the knee, and in fact they don’t affect a pure tension-type headache. With Triptans, bout 60 to 65 percent of the population will have their headache taken from a moderate or severe level down to a mild or no headache level. About 30 to maybe 40 percent of patients will be pain-free in two hours. However, not everybody responds to the triptans. Basically, 60 to 65 percent of patients will respond to a particular triptan.

The triptans used in the population for whom they work are extremely safe drugs, extraordinarily safe. In fact, a study of heart safety of the triptans in particular found that there was no evidence of excessive risk of heart complications in patients who took the triptans. However, there are side effects from these medications; Chest pressure, neck squeezing, palpitations, along with other less common side effects like a scalding skin or a burning sensation. The bottom line: triptans are very, very safe when used in the indicated population. They can cause side effects that are annoying but not dangerous.

Preventive Drugs for Migraine

There are other drugs that include the beta-blockers, amitriptyline, topiramate, valproic acid and gabapentin that have either FDA approval or have evidence showing they have some preventative anti-migraine activity. The above stated ones have good, randomized, controlled trial evidence. However, none of these drugs has really performed much better than about 50 to 55 percent of the patients being 50 percent improved in the randomized, controlled studies. There have been random, uncontrolled studies with other drugs but just the fact that these were uncontrolled studies more or less excludes them from any serious scrutiny by professionals.

As with most drugs, the side effects can out-weigh the good from the drug. It is your responsibility as a patient to ask questions of your doctor. Know the facts and be able to make the best decision for yourself. After all, it is your life. Much of the research done does not take into account any long term effects. Who knows if these drugs would raise the risk of cancer later in life.  Weighing your options, is the best way to safe-guard your health for years to come.

Tags: chronic migraines, migraine headaches, Migraine Support Formula, Prescription medication, preventative migraine treatment