Why it might be time to go back to your GP
By: Rachel Baxter, Communications Officer, The Migraine Trust
Migraine can be an incredibly frustrating disease to live with. It’s poorly understood, there’s a lack of awareness about it and there’s no one-size-fits-all treatment or cure. There is a range of options when it comes to treating migraine, but everyone responds differently and some treatments can come with unpleasant side effects.
Lots of people give up with their GP after trying a couple of medications that haven’t worked, which is very understandable. However, while trying multiple drugs and going to the doctor regularly can be frustrating, going back to your GP can really pay off. When it comes to treating migraine, perseverance is often key.
Don’t put up with pain
If you’re putting up with regular migraine attacks but haven’t tried many migraine medications, it’s time to pay your GP a visit. There are quite a few different types of drugs you can try, so don’t feel like you need to give up if one or two haven’t worked for you. Keep going back and trying new treatments and you might be pleasantly surprised. If you’re finding your GP to be unhelpful or you’ve been through every option with no success, it’s worth asking them for a referral to a neurologist or headache specialist, particularly if you have chronic migraine or your attacks are having a big impact on your life.
It might also be helpful to do some research and go to your GP equipped with some knowledge about the treatments available and which ones you think you’d like to try, and they can then advise you. Keeping a headache diary and bringing it with you will also help your GP decide which treatments to prescribe, and help to identify any patterns to your migraine or any triggers to avoid.
Persevering with preventives
Broadly, there are two types of treatment you can have for migraine; acute and preventive. Acute treatments are those that you take when you feel a migraine attack coming on and they work to stop the attack and relieve the pain. Preventive drugs are taken each day and aim to reduce the frequency and severity of your attacks. If you experience four or more attacks per month, preventives are likely to be a good option for you.
Preventive medications include beta-blockers, certain antidepressants, epilepsy drugs and calcium channel blockers. These drugs were developed for other conditions but are effective against migraine. The latest preventive, calcitonin gene-related peptide (CGRP) medication has been specifically developed to prevent migraine and has been life-changing for many people. At the moment, it is only being prescribed by neurologists or headache specialists, so you’ll need a referral to try it.
Frustratingly, preventive treatments can take some time to make a difference. You ideally need to take them for at least three months to see if they’re working for you. Many people stop taking their preventive medication before the three-month mark because they aren’t seeing a difference. If you’ve started a new preventive that doesn’t feel like it’s working, it’s worth sticking with it for a few months before coming off it.
Taking acute medication
Acute migraine treatments include over-the-counter painkillers like paracetamol and ibuprofen, anti-sickness drugs call anti-emetics, and triptans which were developed specifically to treat migraine. Many people find that painkillers don’t help their migraine attacks, so if this is the case for you it’s worth asking your GP about triptans as they can be very effective – they treat the pain and nausea symptoms of migraine at the same time.
There are multiple different triptans out there, so if you try one and it doesn’t work for you, don’t give up. Your GP will be able to prescribe you with a different triptan that might work better. Triptans can also have side effects like fatigue, nausea and chest tightness, so if these side effects get too much don’t just put up with them or give up on medication. Tell your doctor and you’ll be able to try something different.
The peril of painkillers
Something to consider if you take acute medications for your migraine is how often you take them. When taken too often, painkillers, triptans, drugs containing caffeine and a drug call ergotamine can lead to medication overuse headache. This is where you start to develop more frequent headaches, or ‘rebound headaches’, but the medication is actually the cause. You then take even more medication to ease the symptoms, creating a vicious cycle of pain and medication overuse.
If you take over-the-counter painkillers on 15 or more days each month, or triptans, opioid painkillers, ergotamine or combination painkillers on 10 or more days, speak to your GP. They’ll be able to help you come off the drug in a safe way and prescribe you an alternative that won’t cause the same issues. You might then see a significant improvement in your migraine.
If you’re taking opioid painkillers like codeine for your migraine it’s important to speak to your GP to find an alternative. While these drugs might ease the pain, their benefits are short-lived, they can cause medication overuse headache and they are very addictive.
There are many ways to treat migraine and you shouldn’t have to just put up with frequent pain. In addition to acute and preventive medication, other treatments like Botox injections, certain medical devices, and even supplements like magnesium and riboflavin help many people manage their attacks. So, if you feel stuck and haven’t found anything that works for you, don’t give up. It’s likely there are other treatments you haven’t tried yet that might be more effective. While it might feel tiresome, keep going back to your doctor because the next treatment you try might make a big difference.
If you’re struggling to access treatment or referral to a specialist, you have questions about migraine treatments, or you’ve exhausted everything and need advice or support, we’re here to help. You can call our free helpline on 0808 802 0066 or email us at firstname.lastname@example.org.