Migraine Abortives and Rescue Meds Confusion
From recent conversations, it seems that there is some confusion about what medications can and cannot abort a Migraine attack. This can be important because, whenever possible, it is better to abort an attack than to simply treat the symptoms.
There is growing evidence that Migraine is a progressive brain disease. White matter lesions are being found on the brains of Migraineurs, but the long-term implications of these lesions is yet to be determined. We know that blood vessels in the brain become dilated during a Migraine attack, and that the tissue and nerves around those vessels become inflamed. There is also still much to be learned about the long-term effects of that inflammation, but nobody can argue that reversing the vasodilation and inflammation should be a primary goal in treating Migraine attacks.
Migraine abortive medications can reverse the vasodilation and inflammation. Some other medications may help with the inflammation, but they do nothing to address the vasodilation. They may be able to mask the pain of a Migraine attack for a few hours, but theycannot abort an attack.
Aborting a Migraine attack means working in the brain to stop the Migrainous process. Stopping the Migrainous process also relieves both the pain of an attack and its other symptoms such as nausea, photophobia (sensitivity to light), phonophobia (sensitivity to sound), mood changes, and more.
The following are Migraine abortive medications...
- The triptans: Imitrex (sumatriptan), Maxalt (rizatriptan), Zomig (zolmitriptan); Amerge (naratriptan); Relpax (eletriptan); Frova (frovatriptan); and Axert (almotriptan).
- Ergotamine derivatives: DHE 45 (injectable) and Migranal Nasal Spray.
- Midrin and Epidrin -- same medication, just made by different companies.
Pain medications, including NSAIDs, are not Migraine abortives. They are often prescribed as "rescue medications" to be used when we've already used abortives the maximum number of days in a particular week or to relieve the pain of an attack if abortives have failed.
The best of all Migraine abortives is a natural one -- sleep. If we're able to get into a deep, restful stage of sleep, a Migraine is usally aborted simply by sleeping because that kind of sleep stops the Migrainous process in the brain. Unfortunately, the pain and other symptoms of a Migraine can sometimes prevent us from getting that type of sleep.
For more information on this topic, please see Preventive, Abortive, and Rescue Medications - What's the Difference?