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Treatments for chronic migraine

Aug 18, 2021

2 types of treatments

There are 2 main types of treatment to treat chronic migraine:
  1. Crisis treatments .
  2. Background treatments .

Crisis treatments

#1 Seizure treatments are meant to stop the seizure when it starts . Treatments are triptans and ergot derivatives .

Background treatments

#2 Background treatments are prophylactic treatments, that is to say they must be taken to prevent migraine attacks, to act on the frequency and intensity of the latter.

Most disease-modifying treatments are not specific to the pathology, in fact we find: antidepressants, beta-blockers or even antiepileptics.

Recently a new treatment has emerged, specific to migraine: CGRP antibodies . Although existing, this treatment is not within everyone's reach. To be eligible, you must have chronic migraine, have failed at least 2 conventional treatments, its cost is 3000-5000€/year/patient and is not, for the moment, reimbursed by security. social. In addition, the long-term effects are not yet certain, but they have been proven in several very promising clinical studies.

The aim of a long-term treatment is to preserve the “crisis capital” or “triptan capital (crisis treatment) of the patient. It should be known that each patient has a “capital crisis” and the treatment of crisis can itself triggered headaches , after a certain time, a certain dose, this is what is called 'headaches by drug abuse' . The goal, with a background treatment , is to minimize the intake of triptans , by having an action on the frequency and intensity of attacks.

migraine diary

In addition, it is recommended to keep a migraine diary . The keeping of such a diary will make it possible to collect information on:

  • The pain felt (scale of 1 to 10 for example)
  • Associated symptoms (auras or not)
  • The duration of seizures
  • The time of day when the seizure started
  • If possible, the triggering factor (s) (sleep time, temperature, diet, stress, etc.)
  • Taking medication (which medication, when)

This notebook is to be kept every day for at least 1 month. This will allow the patient and his doctors to be able to follow the evolution of the crises , to have more information on the triggering factors and to help with the establishment, maintenance, change or discontinuation of a treatment .

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