Dr. Jay Discusses Migraine Preventive Measures

Gary W. Jay, MD, DAAPM, FAAPM, Medical Consultant, Raleigh-Durham, NC, discusses migraine prophylactic measures.

Dr. Jay says there are two ways to prophylactically prevent a headache. With cluster headaches, many patients will have a cluster headache in the first REM stage after they fall asleep. Cafergot used to be given to those patients to abort the headache.
 
Menstrual migraines are very difficult to treat once a patient has one. Menstrual migraines are not easily aborted with triptans, however there are two forms of prophylaxis that can be used to treat it: naproxen sodium and frovatriptan. Both are taken twice a day for five days before the menses and, in some cases, through the menses.
 
Dr. Jay notes that not all women get a menstrual migraine on the first day of their menses, but typically every individual woman will have a pattern for when the migraine will occur. Using that pattern, the physician and patient can prophylactically treat the menstrual migraine.