Migraine

Migraine is a neurological disorder marked by recurring, often severe headaches, often accompanied by nausea, sensitivity to light and sound, and sometimes visual or sensory auras. Triggers include stress, hormonal changes, certain foods, and sleep disruptions, with management involving tailored lifestyle changes and medications.

Almotriptan (Almogran)
From £19.95 Select options This product has multiple variants. The options may be chosen on the product page
Eletriptan (Relpax)
From £49.95 Select options This product has multiple variants. The options may be chosen on the product page
Frovatriptan (Migard)
From £24.95 Select options This product has multiple variants. The options may be chosen on the product page
Imigran Nasal Spray
From £29.95 Select options This product has multiple variants. The options may be chosen on the product page
Naratriptan (Naramig)
From £19.95 Select options This product has multiple variants. The options may be chosen on the product page
Rizatriptan (Maxalt)
From £19.95 Select options This product has multiple variants. The options may be chosen on the product page
Sumatriptan (Imigran)
From £14.95 Select options This product has multiple variants. The options may be chosen on the product page
Vydura (Rimegepant)
From £49.95 Select options This product has multiple variants. The options may be chosen on the product page
Zolmitriptan (Zomig)
From £29.95 Select options This product has multiple variants. The options may be chosen on the product page
Zolmitriptan (Zomig) Nasal Spray
From £79.95 Select options This product has multiple variants. The options may be chosen on the product page

Migraine is a complex neurological disorder characterised by recurring, often debilitating headaches, typically accompanied by symptoms such as nausea, vomiting, and heightened sensitivity to light and sound. Migraines can vary significantly in severity and duration, with some individuals experiencing visual disturbances or other sensory symptoms known as aura.

While the exact cause of Migraines remains unclear, they are believed to involve a combination of genetic, environmental, and neurological factors, including abnormal brain activity and the role of certain neurotransmitters like calcitonin gene-related peptide (CGRP). Triggers for migraine attacks can include stress, hormonal fluctuations, certain foods, and changes in sleep patterns.

Effective management of migraines often requires a personalised approach, combining lifestyle adjustments, medications, and preventive strategies.

Migraines Video

What are Migraines and what causes them?

Migraine is a neurological condition characterised by recurrent, often severe headaches. These headaches are typically accompanied by additional symptoms, such as nausea, vomiting, and sensitivity to light and sound.

The exact cause of Migraines is still not fully understood. While it was previously believed that changes in blood vessel size in parts of the brain played a central role, recent research has indicated that Migraines may be related to increased activity in certain brain chemicals and altered signalling between different brain regions. The role of calcitonin gene-related peptide (CGRP) has garnered particular attention in understanding Migraine development. Additionally, hormonal fluctuations, particularly a drop in Oestrogen levels, have been identified as a trigger for menstrual Migraines.

Although Migraine is not classified as a strictly inherited condition, a family history of Migraines is a common risk factor, suggesting a genetic component. These genetic factors may increase susceptibility to the environmental triggers that can provoke Migraine attacks.

What are the signs & symptoms of Migraines?

Migraine is a complex neurological condition with varying symptoms among individuals. There are two primary types of Migraine: Migraine without aura and Migraine with aura, each with its own set of distinct symptoms.

Migraine without aura

This is the most common type of Migraine
Symptoms typically include a severe headache that can be located on one side of the head (commonly the front or side), but it can also affect both sides. The pain is often described as throbbing or pulsating and can worsen with head movements
Migraine without aura may start in the morning or at any time of the day, lasting from 4 to 72 hours
Common symptoms associated with this type of Migraine include nausea, vomiting, sensitivity to light (photophobia) and sound (phonophobia), which may lead individuals to seek a dark, quiet environment
Other possible symptoms can include a lack of appetite, blurred vision, difficulty concentrating, a stuffy nose, hunger, diarrhoea, abdominal pain, frequent urination, pallor, sweating, scalp tenderness, and sensations of heat or cold

Migraine with aura

Migraine with aura is less common than the type without aura and shares many of the same symptoms
A distinctive feature of this type is the presence of a “Migraine aura” which acts as a warning sign preceding the headache
Visual aura is the most prevalent and usually affects one side of the visual field, gradually expanding over 5-20 minutes. Examples of visual aura include temporary vision loss, bright flashing lights, zigzag lines, or perceptions of objects and text rotating, shaking, or boiling
Numbness and pins and needles in the hand, arm, face, lips, tongue, and occasionally the leg are the second most common type of aura
Problems with speech, including vertigo, tinnitus, or slurred speech, represent the third most common form of aura, previously known as “basilar Migraine”
Other variations of Migraine aura involve unusual smells, food cravings, and other peculiar sensations
The duration of each aura is typically a few minutes but can extend to 60 minutes. Importantly, the aura typically resolves before the onset of the headache, which usually occurs within 60 minutes of the aura’s end, but can sometimes begin sooner. In some cases, only the aura occurs without a subsequent headache, referred to as a “silent Migraine”. Many individuals experiencing Migraine with aura also have episodes of Migraine without aura. It is essential to consult a healthcare professional for an accurate diagnosis and appropriate management if you experience Migraine symptoms

How long do Migraines last?

Migraine without aura: The headache phase typically lasts from 4 hours to as long as 72 hours.

Migraine with aura: The aura phase develops within a few minutes and lasts for five minutes to an hour. The headache usually follows within an hour of the aura ending, with a duration similar to that of a Migraine without aura.

A complete Migraine attack involves four phases:

Premonitory Phase: This warning phase occurs in about half of Migraine sufferers and includes symptoms like irritability, depression, fatigue, food cravings, or an intuitive sense of an impending Migraine. These symptoms can appear hours to days before the headache starts

Aura Phase: Only applicable if auras are part of the Migraine, with symptoms such as visual disturbances or sensory changes

Headache Phase: The main headache phase lasting for the previously mentioned durations

Resolution Phase: As the headache gradually subsides, this phase may lead to feelings of tiredness, irritability, depression, and difficulty concentrating

Understanding the phases can aid in recognising and managing Migraine attacks effectively.

What triggers a Migraine?

Migraine attacks often occur without a clear cause, but various triggers can contribute to their onset. These triggers include:

Diet: Fast dieting, irregular meals, consumption of cheese, chocolate, red wine, citrus fruits, tyramine-containing foods, and dehydration

Environmental: Exposure to smoking and smoky environments, glaring light, VDU screens or flickering TV sets, loud noises, and strong odours

Psychological: Emotional factors like depression, anxiety, anger, tiredness, and stress can trigger Migraines. Some individuals experience “weekend Migraines” when they relax after coping with stress

Medicines: Certain medications, such as Hormone Replacement Therapy (HRT), specific sleeping tablets, and contraceptive pills, can trigger Migraines

Other: Factors like menstruation, shift work, irregular sleep patterns, and menopause can also act as triggers

Keeping a Migraine diary can be helpful in identifying patterns related to Migraine attacks. By recording the onset, activities, and dietary intake during each attack, individuals may identify specific triggers and take measures to avoid them.

How can I prevent Migraines?

Combining medical treatment with behavioural strategies and lifestyle adjustments is often the most effective approach for managing Migraines.

Create a calm environment

Find a quiet, dark room when you sense a Migraine coming
Apply hot or cold compresses to your head or neck

Prioritise good sleep

Maintain regular sleep patterns and keep daytime naps short
Relax before bedtime and avoid stimulating substances like caffeine, nicotine, or alcohol

Maintain a healthy diet

Eat at consistent times and avoid skipping meals
Consider keeping a food journal to identify potential Migraine triggers
Be cautious of foods like aged cheese, chocolate, caffeine, and alcohol that may trigger Migraines

Regular exercise

Engage in physical activity to release pain-blocking chemicals and reduce anxiety
Maintain a healthy weight to lower Migraine risk

Manage stress

Simplify your daily life and effectively manage your time
Take breaks when needed
Maintain a positive attitude and find time for enjoyable activities
Practice relaxation techniques like deep breathing

Keep a Migraine diary

Maintain a diary to track Migraine triggers, symptoms, and potential relief methods

What are the treatment options for Migraine?

Painkillers

Paracetamol and Aspirin are effective for many Migraine attacks
Take a full dose as early as possible when symptoms begin
Aspirin may be particularly useful for Migraines, even if it has fallen out of favour for other conditions
Avoid using Codeine-containing medications, as they can worsen nausea and lead to medication-overuse headaches

Anti-inflammatory painkillers

Medications like Ibuprofen can be more effective than Paracetamol for Migraine relief
Take the maximum allowed dose when symptoms start
Consuming these medications with food may help reduce the risk of stomach upset

Anti-sickness medicines

Domperidone, Prochlorperazine, or Metoclopramide can help alleviate nausea and vomiting associated with Migraines
Taking anti-sickness medicines as soon as symptoms appear is most effective

Triptans

Triptans are a group of medicines used to relieve Migraine symptoms
Common Triptans include Sumatriptan, Rizatriptan, and Zolmitriptan
They work by mimicking the action of serotonin in the brain and causing blood vessels to constrict
Take the first dose when the headache is just beginning but not earlier to optimise effectiveness
If the first dose works but the headache returns, you can take a repeat dose within the specified timeframe
If you experience nausea or vomiting, some Triptans are available in alternative forms like nasal sprays and orodispersible tablets to ensure effective absorption
Caution: Triptans should not be taken by individuals with uncontrolled high blood pressure, cardiovascular disease, recent stroke, certain heart conditions, during pregnancy, or while breastfeeding
Triptans are not licensed for those aged over 65

Combining medicines

Some Migraine medications combine painkillers and anti-sickness medicines
This can be convenient, but the dosage of each component may not suit everyone’s needs

Preventative medications

If Migraines are frequent or severe, preventative medications may be an option
Consult a healthcare professional for suitable preventative options such as Beta-blockers and Amitriptyline

When should I refer to my GP?

It is important to see your GP for a first attack of suspected Migraine so that they can investigate thoroughly and provide a definitive diagnosis.

You should also refer to your GP if you experience any of the following:

Severe or prolonged Migraines: When Migraines are exceptionally severe, last longer than usual, or do not respond to treatment
Frequent Migraines: If you have frequent Migraine attacks, consider discussing preventative measures or medication options with your GP
Migraines with aura: Seek medical attention when you experience Migraines with aura, as they may necessitate specific management
Significant lifestyle impact: If Migraines significantly affect your daily life, work, or relationships, consult your GP for a personalised management plan
New or unusual symptoms: When you notice new or unusual Migraine symptoms, such as neurological changes, speech difficulties, or severe vomiting, it is important to consult a GP to rule out other potential causes

Further Information

NHS – Migraine

Patient – Migraine

Patient – Migraine Treatment

Migraine

Almotriptan (Almogran)

Eletriptan (Relpax)

Frovatriptan (Migard)

Imigran Nasal Spray

Naratriptan (Naramig)

Rizatriptan (Maxalt)

Sumatriptan (Imigran)

Vydura (Rimegepant)

Zolmitriptan (Zomig)

Zolmitriptan (Zomig) Nasal Spray

Information

Information

Step 1 - Complete a Short Medical Questionnaire

Step 3 - Express Delivery of Your Treatment

Step 2 - Prescriber Assesses Treatment Suitability

Step 3 - Express Delivery of Your Chosen Treatment

Step 2 - Complete a Short Medical Questionnaire

Step 1 - Select Your Condition