MIGRAINE: PREVENTION
You can minimise the number of attacks you experience through carefully eliminating or minimising your trigger factors. However, we all live in a real world, and it’s just not possible to eliminate all your trigger factors entirely. There will always be those missed meals, the food inadvertently eaten, the” exam to be taken, the stress at work.
Don’t worry alxnit those trigger factors you can’t avoid. Instead, concentrate on minimising whatever you can, especially when you know you’ll be exposed to one or more factors. For example, take a leaf from the book of the woman who says she can drink red wine, but not during the week before her period.
A number of medicines can be used to prevent attacks occurring. These drugs are not pain-killers, nor do they work during an attack. They work solely to prevent attacks occurring – by stabilising your systems so that trigger factors are less likely to provoke an attack. Preventative medicine is of greatest value where the attacks are frequent; it is inconvenient (and expensive) to take drugs for attacks that happen infrequently. It also exposes you to the possibility of side-effects for very little gain. A convenient rule of thumb is that if you get more than two attacks a month, preventative drug treatment is likely to be worthwhile.
Drugs to prevent attacks have to be taken on a regular basis, and it may take them several weeks to have full effects. No drug is completely effective, but propranolol reduces the number of attacks in about fifty per cent of migraineurs.
In women, especially those with menopausal or menstaial migraine, attacks can be prevented using replacement oestrogen, either as tablets or patches. In menopausal migraine clonidine can also help.
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