Title: 
Migraine Headaches

Word Count:
498

Summary:
Nearly 30 million Americans suffer from migraine headaches.  Migraines occur more commonly in women than in men and typically occur in people aged 15 to 55 years.  	A recent study of 171 migraine sufferers, published in the journal Headache, suggests that over-the-counter Excedrin Migraine works better the prescription Imitrex (sumatriptan) for treating migraines


Keywords:
migraine headache imitrex naproxen pain acetaminophen aspirin triptans


Article Body:
Nearly 30 million Americans suffer from migraine headaches.  Migraines occur more commonly in women than in men and typically occur in people aged 15 to 55 years.  
	
A recent study of 171 migraine sufferers, published in the journal Headache, suggests that over-the-counter Excedrin Migraine works better the prescription Imitrex (sumatriptan) for treating migraines.  The patients who took the Excedrin Migraine at the onset of a headache experienced less pain after four hours than those who took Imitrex.

This result is probably true for some patients but not all.  Excedrin Migraine contains acetaminophen, aspirin, and caffeine.  The problem with continual use of this combination is that it often leads to rebound headaches.  You should also not take more than two tablets per day and no more than twice per week.  This greatly reduces your chances of rebound headaches.  If you are experiencing more than two migraines a week, you will need a prescription medication.  
	
Another study found that taking an NSAID, like naproxen, with Imitrex (sumatriptan) works much better than taking either medication alone for migraine headaches.  The researchers concluded that the best combination is 50mg of Imitrex (sumatriptan) combined with 500mg of naproxen. 

Imitrex (sumatriptan) is in a class of medications called triptans.  There are seven triptans currently available in the United States.  They are Imitrex (sumatriptan), Maxalt (rizatriptan), Zomig (zolmitriptan), Amerge (naratriptan), Frova (frovatriptan), Relpax (eletriptan), and Axert (almotriptan).  Triptans are used only for migraine treatment because they are effective only at relieving the pain caused by migraines.  They are slightly useful for some other headache types but not for all headache pain or for any other type of pain.

The current guidelines for migraine headaches state that NSAIDS are first line therapy.  That means they should be used first.  If someone is allergic, or the NSAIDS do not work, then the triptans are the drugs of choice.  
Patients who suffer from migraine headaches should have a treatment plan in the event they get a migraine.  This plan should include both preventive medication and medications to stop the migraine.  The first line medications, NSAIDs and triptans, are the primary choices.  

This study suggests that the NSAID combination of acetaminophen, aspirin, and caffeine is more effective than oral sumatriptan at relieving migraine headache pain, when taken at the onset.  More studies should be conducted to confirm these results since patients with headaches that cause vomiting or require the patient to lie down were not studied.  This study did confirm that both the combination of acetaminophen, aspirin, and caffeine and triptans appear to be effective first-line therapies for patients with migraine headaches.  

I would recommend using a store or generic brand headache medication containing 250mg of acetaminophen, 250mg of aspirin, and 65mg caffeine first, for mild migraines.  This combination costs about 4¢ per pill.  If this is ineffective, or the migraine is severe, move up to the triptans.  They are expensive at about $17.00 per pill.  Anyone with a migraine will tell you that cost is not a consideration when it comes to migraine relief.