Migraine medication: removing the stigma
By: Rachel Baxter, Communications Officer, The Migraine Trust
There are a number of effective treatments against migraine, but few have been developed specifically to treat the condition. At the moment, triptans are the only acute medication created specifically for the short-term treatment of migraine attacks, and calcitonin gene-related peptide (CGRP) monoclonal antibodies (MABs) are the only treatment developed specifically to prevent migraine. Other drugs commonly used to treat and prevent migraine were originally developed for other conditions but have been found to have a positive effect on migraine in some people.
It can feel daunting and confusing to be prescribed medication that’s normally used for a totally different condition from migraine, and we often hear from people with questions or concerns. What’s important to know is that any drugs your doctor prescribes you for your migraine are very safe to take and could significantly improve your migraine.
Taking anti-depressants for migraine
Two drugs commonly prescribed to prevent migraine are anti-serotonergic drugs and tricyclic anti-depressants, both of which are normally used to treat depression. They can both be effective against migraine and tricyclic antidepressants can be particularly helpful for people with migraine who struggle to sleep.
You might feel worried about taking anti-depressants when you haven’t been diagnosed with depression, but they are very safe to take and you don’t need to have depression to use them. It’s thought that they’re effective against migraine because they help to maintain the levels of serotonin and other chemicals in the brain, and fluctuations in serotonin may contribute to migraine attacks. If you do experience side effects while taking these medications, like drowsiness or weight gain, speak to your GP.
Depression and anxiety are more common among people with migraine, so if you think you might have one of these conditions, speak to your GP as the associated stress may potentially be contributing to your migraine. It’s also important to treat both conditions to help you live your life to the fullest. Symptoms of depression include lasting feelings of unhappiness or hopelessness and losing interest in things you used to enjoy. Symptoms of anxiety include restlessness, constantly feeling on edge and difficulty concentrating. The exact link between migraine and these mental health conditions is unclear. For example, it might be that living with the pain of migraine leads to anxiety in some people, while constantly feeling anxious might trigger migraine attacks in others. We need more research to fully understand the connection.
Taking anticonvulsants for migraine
Another type of medication used to prevent migraine that many people feel anxious about taking is anticonvulsants, which are sometimes know as anti-epileptics as they are used to treat epilepsy and seizures. Anticonvulsants commonly used for migraine are topiramate and sodium valproate. If you’ve been prescribed them, they’re very safe for you to take (pregnant women should not take them) and you don’t need to have epilepsy to use them. They’re also used to treat other types of seizures as well as bipolar disorder. It’s not clear exactly why they benefit people with migraine, but it’s thought to be related to how they affect the nerves in the brain.
If you experience any side effects while on these medications, like tiredness, nausea or dizziness, speak to your doctor.
Taking blood pressure medication for migraine
Drugs used to prevent migraine also include a number of medications usually used to treat high blood pressure. You might worry that these drugs will affect your heart or make your blood pressure fall too low, but they’re perfectly safe to take if you’ve been prescribed them. Some people can’t take them, for example people with asthma shouldn’t take beta-blockers, but your doctor will find out whether they’re suitable for you to take before giving them to you. Blood pressure drugs used to treat migraine include beta-blockers, calcium channel blockers and angiotensin II blockers.
If you notice any unpleasant side effects while on these medications, like tiredness, trouble sleeping or feeling sick, speak to your doctor about changing the dose or trying a different migraine treatment.
Unfortunately, certain health conditions and their associated treatments carry stigma even today. Many mental health conditions are stigmatised, which is why some people might feel uncomfortable about taking anti-depressants for migraine as they worry about what other people will think. No illness should carry stigma, and normalising the use of medications like anti-depressants will help to tackle this issue.
We hope this article is reassuring, but if you still have questions or concerns about taking drugs developed for conditions other than migraine, don’t hesitate to get in touch. You can contact our free helpline on 0808 802 0066 or at firstname.lastname@example.org for support or advice. Don’t be afraid to ask your doctor questions about the drugs they’re prescribing you too, as they should be able to give you some helpful information and peace of mind.