Migraine Arsenal Essentials: Abortive Treatment
Credit: Teri Robert
A complete Migraine arsenal includes different types of treatments. Unless there’s a reason we can’t take them, abortive treatments should absolutely be included in our arsenal. Unlike pain relievers, abortive treatments work to shut down the Migrainous process, thus totally stopping (aborting) the Migraine attack and most of its symptoms. Even when abortive medications work well, we can still experience the symptoms of the postdrome phase of the Migraine attack.
There are three types of Migraine abortive medications:
- Midrin equivalents
There are seven triptans. Each of them bind to different combinations of serotonin receptors, which means they all act a bit differently. If one triptan doesn’t work, it’s well worth trying the others. All seven of the triptans are now available in generic form, with Relpax being the last to go generic in June, 2017.
The triptans are:
- sumatriptan (brand name Imitrex)
- rizatriptan (brand name Maxalt, Maxalt-MLT)
- naratriptan (brand name Amerge)
- zolmitriptan (brand name Zomig, Zomig-ZMT)
- almotriptan (brand name Axert)
- frovatriptan (brand name Frova)
- eletriptan (brand name Relpax)
Ergotamine Migraine abortive medications include:
- D.H.E. 45
- Migranal Nasal Spray
Midrin was a combination of acetaminophen, dichloralphenazone, and isometheptene. Midrin was first developed before the current FDA approval process. Manufacturers of medications submitted for new drug approval when Midrin was first made were asked to submit to the FDA their evidence that the drug was effective. The manufacturer of Midrin didn’t comply, and Midrin was withdrawn from the market. (See Midrin for Migraine: What’s Going On?) At this time, there are “generic” medications available that contain the same ingredients as Midrin.
Triptans and ergotamines are contraindicated for people who have a history of or high risk factors for heart attack or stroke. They’re also contraindicated for people with hemiplegic Migraine and Migraine with brainstem aura, although there is some research that they may be safe for those patients.
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