Migraines: triggers and prescribed treatments?

July 18, 2005 2:45 PM

Migraine sufferers, what are your triggers, how quickly/consistently do they bring on your migraines, and what prescription meds work best for you?

I can't tell which one or several of the following are triggers for me: activity after sedentariness, caffeine, sunlight, artificial coloring, sinus problems, aspartame, possibly bad posture while sitting, etc. Some combination of the first five tends to be involved for me, most of the time, but not always. I've had a couple of instances where I'd get a migraine shortly after walking from work to various fast food places and getting a soda with lunch. I've had more instances where I'd get a migraine after leaving a 75 or 90 minute class (where, typically but not always, I'd had a soda and sat in flourescent lighting then left for the sunny outdoors).

I never have migraines at home, on the weekends (except for one time when I was at work), and I've only had one after the hours of noon-6 PM (it was still twilight when it happened), and I think I've only had one on a rainy day.

I can't tell if my triggers are nearly immediate, or if they're longer term but I'm considering the wrong things to be triggers (post hoc ergo propter hoc). I've tried different prescription medicines, and while the first time I took Imitrex, it blew out the migraine in a matter of minutes, I haven't had quite so much success any other time with it, Maxalt, or Zomig, even when I pop the pill as soon as I see the aura, which is always in my right eye (and the pain that follows about 45 minutes later is always on the left side of my head). I'd love to hear from those of you who've isolated your triggers and/or have found successful experiences with prescribed solutions. [Sorry for going on so long.]

posted by kimota to health & fitness (34 comments total)

I've personally never had to take something a doctor gave me to treat a migraine. When I see the aura, it's an Excedrin and a caffeine-based soda (typcially a Coke), and I can typically beat it to the puch. I know I'm still experiencing it, as I tend to feel as if I'm radiating heat from the roots of my hair during a migraine, even if I don't still feel the pain. My migraines are typically triggered by facial muscle fatigue (like from sneezing or squinting for long periods of time) or mental fatigue.

My mother, on the other hand, has chronic migraines, and about once every three or four months has to be driven to the ER to receive a shot to her thigh to treat the thing. The doctors have concluded that her chronic migraines are related to emotional stress, as she's one of those folks that has spent her life burying her problems.
posted by thanotopsis at 2:58 PM on July 18, 2005

I can't comment on triggers because my migraines are injury-based (herniated disc in the neck). I can say that Topamax is extremely effective in managing the problem for me. I haven't had one migraine since I started taking it.

I also use the Excderin/caffeine trick for headaches in general - per my neurologist's suggestion.
posted by glyphlet at 3:06 PM on July 18, 2005

Trigger: stress combined with lack of sleep. Cure: plain old aspirin and rest in a dark room. But I don't get migraines if I'm having acupuncture (semi)-regularly.
posted by Specklet at 3:15 PM on July 18, 2005

Light cause mine...office / fluorescent lighting mostly cause my migraines, but I've had the rare one caused by too much sunlight or glare from the sun. In fact, I think my first migraine was caused looking out a window during church, and I had to rest in a bathroom on the cold tile. As migraines do, not every office lighting cause mine, and the longest I've gone without a migraine was over a year, but last year, it seemed I had one every month, but maybe that was work stress-related.

I know I'm getting a migraine with the slightest aura in my field of vision, usually in the corner or some other little-used area...never in the center. Then it slowly grows to almost cover my complete sight. I figure I have an hour before my headache creeps up, and then about 30-45 minutes after that before nausea sets in.

I have never tried prescription medicine for mine - I too try the Excedrin Migraine and liquid caffeine...I'm having better success with stopping them, but majority of the time the visual aura grows and the pounding worsens....then they stop, and I'm bed and bathroom bound (nausea) for the next 4-6 hours. Sadly, though, as I've gotten older, the dull pain lasts into the next day, and sometimes the day after...before, I'd be back to 100 percent by the night.

Non-medicine treatment I've tried: cold rag on head and eyes with as little clothing as possible, since I feel better cold and shivering takes my mind off the pain. And I think I've even stopped or slowed a migraine by thinking to myself, "No...not today. I can't and won't let this happen."

What's strange is that all the women in my immediate family (except the missus) get them, but my Dad doesn't - it's mostly a woman-centric health issue. I find it hard for my coworkers and friends to understand how bad these things are...how much pain I go through. They think it's just a bad headache...if they only knew or could experience just one.
posted by fijiwriter at 3:16 PM on July 18, 2005

Mine are triggered by my period coming on (though those are relatively minor) and by exposure to allergens (cats particularly).

I had really horribly migraines several times a week as a teenager and my doctor was reluctant to prescribe anything as she worried that teenagers had higher likelihoods of becoming addicted. I'm sure if I had pushed she would have given me something, but I didn't want to become addicted to anything either and I think the migraine treatment options weren't that great back then anyway. She told me to take Tylenol *before* the pain started and that's what I did (and do). It doesn't really help with the nausea or sensitivity to light, but it definitely minimizes pain.

Er...also, anything you can do to draw blood away from your head as soon as you feel the migrain coming on. Putting your feet in hot water is one method (though, I find it can be difficult to make the effort to get up and get hot water etc. etc.), but there are other methods of drawing blood away, just use your imagination.
posted by duck at 3:24 PM on July 18, 2005

You might also want to look at the quantity of water that you drink every day. I suspect that it is not enough.

I have a migraine every month or so, and my trigger is wine and dehydration. I just returned from a week's vacation where I drank four or five litres of water every day. I didn't have any of the usual headachey symptoms in the morning, and didn't get a migraine either.

If I have a glass of red or white, I better have two or three glasses of water before retiring, or else there will be a full-blown, two-day migraine waiting for me the next day.
posted by seawallrunner at 3:45 PM on July 18, 2005

Mine are triggered by petro-solvent smells like diesel, gasoline and especially lacquer thinner; aspartame; certain hops, especially Hallertau; and caffeine withdrawal. The lacquer thinner and caffeine withdrawal headaches are about 95% predictable; the rest less so.

Everything I take for my migraines is physician-administered, but in general I start with a cup or two of strong black coffee. If this fails I move to 650 mg of aspirin and/or 1200 mg of ibuprofen. My migraines are fairly rare, so after that I just wait it out; if it gets worse instead of better, usually I just lie down.

I do have visual aura on occasion, but they are always a little bit different. In general though I get multi-colored sparklies in bizarre amoeboid shapes; they look like static on a TV that doesn't have its colorburst killed, with yellow, green and red prominent. When they expand they leave scotoma (visual dead space) in their wake. The visual aura lasts exactly 14 minutes - it's like clockwork. Frequently I don't even get the headache afterwards.
posted by ikkyu2 at 3:53 PM on July 18, 2005

At the risk of muddying the diagnostic waters, you *may* also be experiencing cluster headaches - the stabbing pain in one eye and/or side of the face is a possible clue. Check the other linked symptoms to see if they apply. My other symptoms included nothing for weeks/months, then one a day at about the same time for a few weeks. Environmentally, if you tend to get them at work but not at home, maybe bad air-con is a suspect. AC used to give me cluster headaches.

The only thing that really worked for me was having massage/chiropracty on my upper back/shoulders/neck. However chiropracty is not necessarily for everyone.

Good luck!
posted by carter at 3:59 PM on July 18, 2005

Caffeine withdraw, red wine, beer, stress, and not enough sleep are one's I know about.

Sometimes an advil and a coffee or coke will stop it from progressing, other times I need something like Imitrex. If all else fails Tylenol 3 helps mask it until it goes away.
posted by btwillig at 4:17 PM on July 18, 2005

I started getting migraines when I was on the birth control patch; when I changed my no-baby method they went away. I just stayed in a dark room and napped, taking advil occasionally. Much sympathy for those who get them often -- migraines suck ass.
posted by sugarfish at 4:19 PM on July 18, 2005

When you say you have a soda, are you having a diet soda? I get wicked migraines after drinking any sort of diet beverage. Sometimes it takes a few hours to kick in, but it's miserable once it does. I typically take a few tylenol pm's and nap in a totally dark / quiet room until they pass. But I just avoid anything "diet" or artificially sweetened.
I when I started getting migraines as kid the doctor told my parents that nutrasweet, chocolate, caffeine, or sulfites (from wine or some dried fruits) can also be triggers. I avoided all of these for a while, and then added them back one at a time until I figured out it was the artificial sweeteners.

[On a side note; my mother is very sensitive to sulfites, which I guess is what can cause those nasty migraines from wine. She's been able to get around it by staying away from domestic wines. I guess someone told her that imports don't have as many sulfites - if that makes any sense?]
posted by sarahmelah at 5:29 PM on July 18, 2005

For me, triggers include getting too much sleep or not enough, sometimes noise -- particularly if it's loud and constant, and sometimes stress. I also tend to get them in cycles, so there'll just be a time where I'll just be more redisposed to have a migrane.

As for medicines, I'm one of the 2% or whatever that Imitrex doesn't work on (in fact, it tends to make my migraines _worse_, which sucks), although Maxalt works pretty well for me, though it's very expensive. But since that doesn't work for you, for prescription, I used to take Anaprox, which is Naproxen Sodium in prescription strength (available OTC as "Aleve" among other things -- I usually take a higher dose than they mention on the bottle, though, that's basically about the same as what I was taking in the prescription form). This doesn't work as well, though, so I typically just save the Maxalt for when I am ready to saw off my head, at which point it usually knocks it out or at least puts a good muffle on the pain so I can, you know, think.

Along with the anaprox/aleve, a couple of my neurologists told me that it can help to take a can of coke with it -- even though caffiene can be a migrane trigger, the smallish amount of caffiene in a coke can tend to "jump-start" (their words) the naproxen sodium, and help it work better and sooner. During high school, I was having constant headaches, so I'd typically take the pills and have a coke every morning for breakfast. (initially kind of repulsive, but I got used to it.)
posted by Rev. Syung Myung Me at 5:33 PM on July 18, 2005

When I get a migraine nothing really helps it, if I feel one coming on I have a coffee, or something with caffeine and it tends to fade away, but if it gets to the point of no return that's it, I'm done for the day. I then go into my room, make sure it's dark, and pop a gravel and sleep it off. I have no idea what triggers mine, they usually just hit me.
posted by bluehermit at 6:00 PM on July 18, 2005

My wife migraines. No idea what her triggers are. Mersyndol works for her if she takes it when she's got the aura, not after. Active ingredients are Tylenol, codeine, and a muscle relaxant.
posted by five fresh fish at 6:21 PM on July 18, 2005

Triggers: stress, heat, light, noise, hunger. It's erratic though, sometimes they happen, sometimes they don't. The worst migraines are the one's I wake up with.

If I can take Excedrin Migraine at the start of it, it nips it in the bud about 80% of the time. Otherwise, I have a couple pieces of toast (helping to get blood out of my head and to tone down nausea) and go to bed.

I've never taken a prescription drug for migraines.

Good luck in finding your relief.
posted by deborah at 6:36 PM on July 18, 2005

Imigran, which I inject with a self-injector, works for me. It means the difference between a day and a half in bed and vomiting every 20 mins at the migraine's peak, and going on with my day as usual.
posted by Pigpen at 6:37 PM on July 18, 2005

I wish I understood my triggers better, but aspartame is most definitely NOT one of them.

As far as I can tell, exercising after a flight tends to trigger a migraine for me, so I'm always best off it I wait a day or so after flying.

I had such severe and frequent migraines when I was in high school that I was on propanolol (Inderal) as prophylaxis for several years. That all stopped when I turned 18 or so, as did the frequent migraines.

I've tried Imitrex without much success, and have found that taking a heavy-duty ibuprofen (800 mg or more) is the only thing that even comes close to helping. I try the caffeine route, but that never works very well for me.
posted by yellowcandy at 7:02 PM on July 18, 2005

Imitrex has been a miracle drug for me. I take 100 mgs. as soon as I realize that my funny feeling is a migraine, and 95% of the time, that's the end of that. Nothing else I can take at home has ever worked. Very occasionally, I'll need another dose. Very, very, very occasionally, I'll need to go to the ER for stuff in my veins. I have assorted prescriptions for narcotics and barbutirates, but they don't do much more than make me feel woozy.

My most frequent trigger is PMS. I get migraines far more often during that magic week than at any other time.

Weather pressure changes are what REALLY do me in, however. Right before a big storm, or in a week like this one, where the weather is all over the place, I'm miserable. I think that's why for the longest time, I assumed my problem was sinus-related.

Bright lights are horrible, but flashing lights, like in big funky stage shows, are pretty much guaranteed to go to my head.

But, in conclusion, I LOVE IMITREX.
posted by houseofdanie at 8:28 PM on July 18, 2005

Er. That's "barbiturates," just in case anyone wanted to look 'em up without a blank stare from Google. :P
posted by houseofdanie at 8:30 PM on July 18, 2005

My primary trigger is MSG, and I've found the information at these sites very helpful: Truth in Labeling and MSG Myth. Before realizing that MSG is hidden in so many things I eat (flavored potato chips, frozen dinners, canned soups), I wasn't able to effectively eliminate dietary triggers. It was a tofu dog I had at a cookout that got me looking. I had a KILLER migraine afterwards and decided to look up all the weird ingredients on the side of the package.

I have had a few headaches from red wine and cured meats, but honestly, it's almost always traceable to MSG.

The only other trigger I've noticed is that in the few days after I fly, I'm more prone to get migraines, although those are usually low-grade ones, not the 3-day nausea-fests I get after a dose of MSG.

I found this book enormously helpful as well.

I have never taken drugs for headaches. Maybe I'm being pigheaded, but I think that if I can remove triggers, that's a much better route.

Good luck. Migraines SUCK! I haven't had one in a few months.
posted by abbyladybug at 8:39 PM on July 18, 2005

Bright sun, changes in the weather, eating too many carbohydrates, citrus fruit, not enough sleep, too much sleep, fluorescent lighting, new one for me - getting my period, stress, strong smells, are all triggers for me. But its erratic, sometimes I can eat lemons/limes/oranges without any problems and at other times its a sure fire way to get a migraine.

I've tried ergot, didn't do a damn thing for me. Imitrex was next but went into anaphylactic shock. Sibellium was next up, it worked wonders for me, I was headache and migraine free for about a year and then I developed parkinson's like symptoms and had to be taken off of it. Now I take Tylenol with codeine, use ice packs on the back of my neck and try to lie down in a dark room but I get extremely restless and usually wind up pacing, wishing someone would lop my head off.
posted by squeak at 9:41 PM on July 18, 2005

Mine are mostly triggered by stress. Imigran (as a nasal spray) works wonders for me. The stuff tastes absolutely vile as it trickles down the back of my throat, but afterwards I can remain functional, if a little spaced out.
posted by Ritchie at 12:26 AM on July 19, 2005

Stress, sleep, hormones, raw onions, severe weather changes, but some just come for no reason that I can figure.

I saw a neurologist in May (see my earlier question about it and, BTW, thanks again to everyone for the advice) and this is my new regimen:

- Atenolol (blood pressure med) daily as a preventative

- Anaprox (prescription Aleve, mentioned above) the minute I get that uh-oh feeling. Not waiting to see if the uh-oh feeling actually turns into a migraine because, duh, they always do for me.

- Relpax if the anaprox doesn't work after about 15 min or so

- Supposed to take an anaprox daily the three days before my period, but I haven't been doing that.

The result? Knock wood, seven weeks without a migraine or even much of a headache to speak of. (yay)
posted by SashaPT at 4:03 AM on July 19, 2005

I have been tracking my triggers for almost two decades. First let me tell you a smidge about myself. I'm a 30 something male who has had migraines since I was 5.

I have two distinct auras. One is like static on the TV with lots of colors. This aura signals a migraine that will respond to triptans (Imitrex, Zomig, etc).

The other aura is much more severe. It looks like a thin bright cloth draped in front of of me just to one side of center. Over the course of the next 20 minutes it will enlarge and grow more intense. As it grows, it will move to the left and eventually out of my field of vision. This is followed by 20 minutes of calm before the pain begins. This aura responds to no medication.

Each aura is accompanied with yawning, an almost light-headed feeling, confusion, weariness, and I can feel the expansion of blood vessels all over.

My triggers are well known to me. Nutrasweet/Aspartame/Phenylalanine (all the same stuff) will cause a migraine in less than an hour. I consider this poison and treat it with more care than insecticide.

Peanuts, especially peanut butter, if consumed for 5 or more days straight, will trigger a migraine.

Talking or writing about it can trigger one. Avoiding one after this involves a great deal of concentration.

An extended high pressure system of more than 5 days may trigger a migraine, but this is never the sole trigger. This is a contributing factor. It goes along with the next two.

Glare from the sun, bright light or flashing light. This is difficult to assign a time frame. It depends so much on the intensity, duration, and contributing factors like the previous trigger.

Insufficient fluid intake.

I don't drink, so I have no idea if alcohol is a trigger for me.

Stress and worry can trigger a migraine, but almost exclusively it begins after the event has completed.

Regarding medication. I had been prescribed Inderol, a beta blocker, when I was a teen. New research negates much of the thinking that lead to this being prescribed. I have tried Imitrex, which worked at the beginning, but failed later. As unbelievable as this may sound, I have learned to duplicate the effect of Imitrex without taking the medication. Allow me to explain.

When I took Imitrex, always by injection, I would feel a tightness in my face and neck. This I can only assume was the effect of the medicine on my blood vessels. Regardless, I have learned that by thinking about that tightness, I can duplicate it at will. When I do, I feel it mostly in my forehead and high on my cheeks and not so much in my neck. This is now my best offense against migraine. This is nothing terribly special and the concept can be demonstrated easily in most people.

Close your eyes and think about warm or sweaty hands and palms. This is the brain willfully controlling automated functions of the body.

I once saw a hypnotized person be told he was going to be touched by a red-hot branding iron. The hypnotist touched his finger to the mans arm and a blister immediately formed. This blister was not, obviously, the result of heat applied or an autonomic response by an uncontrollable system. There's more to it. I don't understand most of it, but I do recognize it.

For what it's worth, I find my migraines come in cycles that can last more than a year. They will occur more frequently over a four month period than the rest of the cycle. This period is not associated with any season, but once it starts I know what to expect. Then I will have few or none over the next 8 to 10 months.

Feel free to contact me directly if I can help any more.
posted by kc0dxh at 7:24 AM on July 19, 2005

My triggers are hormonal (PMS & the last day of my period), low blood sugar, not enough protein/iron in my diet, certain heavy mint smells, being dehydrated, dramatic change in elevation, caffeine withdrawl. If I don't wear sunglasses, I will get at least a low level migrane.

Have you had an eye exam lately? I was getting really bad migranes until I updated my glasses. If you're concentrating/reading/taking notes under florescents, that could be eye strain.

I take Imitrex and it keeps migranes from being a killer, but its not a cure all as others have said. My doctor has also prescribed inderol as a preventative, but the side effect list is freaky enough that I've skipped it so far. He suggested that Prosac might help the migranes, but I've avoided that route as well.

Being hypnotized (by a licensed hypnotherapist, not a circus-type guy) helped me control the onset and deal with the pain so I wasn't incapacited for days. It's just really, really cool to feel in control of them as well (as kc0dxh gets at).
posted by Gucky at 11:20 AM on July 19, 2005

I've been taking feverfew every evening, after seeing it mentioned on a NHS website. This has cut down the number of migraines I get by about 80%.

I know you specified prescription meds, so forgive me if this isn't useful, please.
posted by QIbHom at 11:56 AM on July 19, 2005

Triggers for me include sudden large drops in barometric pressure, stress, relaxing after being in a prolonged state of high-stress, bright sun, flickering light, changes in sleep patterns, certain types of hard liquor and wine, unplanned changes in caffeine consumption, hunger, and nagging aches and pain. If I don't get rid of a nagging low-grade headache, it is fairly likely to "bloom" into a week wrecking episode. I tend not to get migraines when I'm too busy to think, but I'll get one as a follow-up when I'm trying to relax. The most consistent trigger used to be being under constant stress for weeks at work, and once I completed whatever was causing stress, I'd up wake with either a low-grade or a 2 day "just kill me" headache.

I've tried Imitrex, Relapax, Zomig, Maxalt and a number of older migraine remedies without any real success. Sometimes they make me puke and then I feel a little better, but I don't really need drugs for that. Emptying my system (and then some) generally makes my headaches lessen enough so I can will myself unconscious, but the catch is I may get dry heaves and start considering a quick death as a reasonable alternative. I continue to try new drugs, but I rely on narcotic painkillers and a quiet room as the only sure-fire migraine remedy.

I had a "hot poker through the eye" migraine that left me useless for 3 weeks exactly 1 year ago. I'm praying that never comes back, but I often think I get migraines on some schedule. I'm used to headaches, but the pressure behind the eye type make run-of-the-mill migraines seem desirable by contrast. Good luck on avoiding whatever makes your head ache.
posted by McGuillicuddy at 1:15 PM on July 19, 2005

I'd also like to add that I agree with kc0dxh about headache cycles. I once went a couple years without a headache and thought I was cured. But generally I'll have a bad 1-4 month stretch, followed by only the occassional low-grade headache for many months. Sometimes during a bad stretch, I have a sense of doom or hopelessness that I think might be a trigger itself.
posted by McGuillicuddy at 1:26 PM on July 19, 2005

A Vitamin B2 regimen (Riboflavin) has supposedly been shown to be associated with migraine relief. I've only proven it turns your pee really, really yellow, but YMMV. (About the relief, that is.)

Personally, I used to experience migraines to the tune of once a week. Some came with "auras", which are -- according to my opthamologist -- "optical migraines", or a pinching of the optical nerve by surrounding blood vessels. I mention this because "auras" are also thought to be caused by the same mechanism the pain is -- constriction/deconstriction of blood vessels.

Then...I went on a diet. It was South Beach. I wasn't really overweight, but when the wife diets, the whole family does. :)

S.B. isn't a trendy "low carb" diet -- it's a "right carb, right fat" diet that promotes good vascular health.

When I read the S.B. book, and came to the part about how it cleaned up blood chemistry and helped vessels work better...I started to wonder if it would help migraine sufferers...

Now I probably get one migraine a month -- IF that. I'm still basically on "phase 3", which is where you end up eating more of what you were used to before the diet, but with some more common sense.

Was it S.B.? Was it my expectation that S.B. would help? Beats me, but there's a big difference in frequency and severity to what I used to have. Good luck!
posted by catkins at 2:08 PM on July 19, 2005

It's also a good idea to stay well away from Depo Provera.

Migraine triggers are hard things to pin down for me. I used to think that light-strike and petrol/diesel would set me off. I'd say to people 'you know those really intense, crushing days where every reflective surface seems to bounce light into your eyes, and it hits you like a hard punch?' And they'd say, 'uh, no. What are you talking about?'

Then I realised that what I thought were triggers were actually symptoms of a nascent aura, which caused me to be hypersensitive to light and certain smells. So yeah, the cause/effect relationship is a hard one for me to work out.

I'm fairly lucky, though. If I can lie down and sleep for 20 minutes or so when I first sense things going 'wrong' in my visual field, I'm usually fine when I wake up, if a bit fragile for a few hours.
posted by Sonny Jim at 5:23 PM on July 19, 2005

I forgot the weather thing - changing from nice to wet weather can bring them on as well.

...if a bit fragile for a few hours.
Ah yes, what I call a "migraine hangover." Mine usually lasts through the next day.
posted by deborah at 10:07 PM on July 19, 2005

Several people have mentioned triptan drugs, like Imitrex and Relpax (relpax in pill form works faster and better than Imitrex in pill form, but is more expensive). But if your migraines come on fast and your digestion is upset, the pill may not enter your bloodstream in time. You can also get the triptan drugs in self-injectable form (subcutaneous) and they're really easy and work fast (not for everyone, as noted, but for most folks I know who have tried them).

Mine are always triggered by lack of sleep, not eating, or dehydration and overheating. Exhaustion combined with any of these is an absolute guarantee.

Take medication fast before the nausea sets in, if possible. Best over-the-counter medication (as also mentioned) is Excedrin, hands-down. The caffeine in the pill helps, as does the combination of painkillers. It's hands down far better than plain advil or tylenol or something and works well in a pinch if you take them the minute you suspect a migraine might happen. I've also discovered that an icepack over the head and occasionally one over the stomach can help keep the pain down long enough for the medication to kick in. It's a race. If the pain gets too bad too fast, I vomit and the medication is wasted (I have to guess as to whether or not any absorbed and whether I want to take more). Having people read to me is wonderfully distracting and believe it or not, the right kind of distraction helps. Anything to help relax. Dim light is good; so is cold air.

Every once in a while I have to go to the emergency room for a shot to knock me out. Not often though. Anything that can make you sleepy enough to sleep it off would probably work. Talk to your doctor about triptan drugs though. Those are the ones that work most consistently as of now.

Oliver Sacks (the author of "The Man Who Mistook His Wife for a Hat), also wrote a neat book about Migraines. Fun reading.
posted by digitalis at 11:49 PM on July 19, 2005

I had been prescribed Inderal, a beta blocker, when I was a teen. New research negates much of the thinking that led to this being prescribed.

That's true, but Inderal still works to prevent migraines. It's the first drug I try in non-asthmatic, non-depressed persons who are losing time from migraine more than 3 times per month. I'd estimate it completely eliminates migraine in half of them. And these are people referred to me because some other doc had decided that he needed help - i.e. severe migraneurs.

In general, it's been that the more we learn about the causes of migraine, the less good are the theories that caused us to prescribe things that help. However, the things that help still help.
posted by ikkyu2 at 12:09 PM on July 24, 2005

Caffeine can be really dangerous if you get headaches more than once or twice a month. It causes rebound.

I urge anyone who hasn't dealt with their migraines, who gets them a couple of times per month or more, to talk to a doctor.

My personal triggers: sleep is the biggest. Not eating the second biggest. Post-stress as described already. Chocolate and other caffeine stuff...

I went on the migraine diet described in Heal Your Headches (linked above), and when I eat things that are on the list, I can feel them... so there are a fair number of triggers that I just hadn't noticed. Raw onions, for example.
posted by YoungAmerican at 3:12 PM on May 30, 2006