I often experience prodrome phase before my migraine attack. Once I recognize the prodrome, is there a way to "treat" it so as to abort the on-coming migraine? I have chronic migraine, so taking an NSAID or other pain medication makes me worry about rebound headaches.
Thank you, Julie.
At present, there isn't any clear evidence for treating migraine during the prodrome phase. When treating during the aura phase has been studied, it has not appeared to be the best time, and so treating at the first sign of pain has remained the primary recommendation. However, there are some people who can treat their migraine successfully prior to the onset of pain, and therefore it is not unreasonable to at least give it a try with an abortive (preferably one less likely to lead to medication overuse headache, aka rebound).
What your prodrome can do for you is give the warning that you need to be prepared to treat when the pain starts. It can also be a reminder to avoid anything that can act as a trigger or an aggravator of your migraine. Be especially careful to avoid dietary triggers, get adequate sleep, drink plenty of fluids, etc. While these may not stop the pain of migraine from starting, it may help to limit the degree of your migraine symptoms. Here are a couple of links about the prodrome for you:
Thank you for your question,
David Watson, MD, and Teri Robert
About Ask the Clinician:
Dr. David Watson is a UCNS certified migraine and headache specialists and director of the Headache Center at West Virginia University. Je and Lead Health Guide Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Watson or more about Teri Robert.
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Published On: September 16, 2014