A variety of drugs have been used to help treat headache pain. Aspirin, ibuprofen, and naproxen all are NSAIDs, which work by blocking natural enzymes and proteins that contribute to pain and swelling. And prescription triptans, including Imitrex, act on the neurochemicals that cause pain. But experts say there are other options.
Biofeedback: This form of relaxation training teaches you to read your body’s responses to stress. As you become more aware of your own signals—a clenched jaw, shallow breathing, a tight neck—you learn to control them, and this results in fewer and less-severe headaches. This nondrug treatment may teach you a useful lifelong skill, but it can be a bit pricey. Formal training, which is offered at many headache clinics, can run as much as $850 for 10 sessions; some insurance programs will cover a portion of the cost. Home systems are available for as little as $100.
Acupuncture: In a huge German study, researchers looked at more than 15,000 people with migraine and tension-type headaches. Results showed that those treated with both acupuncture and regular medical care improved significantly more than those who had regular medical care alone.
Botox: Widely known as a beauty procedure, Botox is also used off-label to treat migraines. Injections are given in the forehead, around the eyes, at the temples, or on the back of the neck. Treatment costs $700 to $1,200, and studies show that it can relieve headaches for up to three months.
Supplements: Magnesium, co-enzyme Q10, vitamin B2, feverfew, and butterbur all have been shown in studies to help ease headaches. Talk to your doctor before taking them. Upside: These treatments are all-natural and relatively inexpensive. Downside: It may take a few months to see results.
The new meds:
Treximet: This Rx, which became available last year, combines the existing migraine medicine Imitrex with naproxen to treat migraines. Studies show the two-drug combo can be more effective than taking either medication alone, and a single dose has a longer effect.
Migralex: Just out this spring, this over-the-counter pain reliever combines aspirin and magnesium. The magnesium relieves headaches on its own and may also help the stomach absorb and tolerate aspirin. On the downside, aspirin may upset some people’s stomachs, and magnesium can sometimes cause diarrhea, says Merle Diamond, MD, a headache specialist at the Diamond Headache Clinic in Chicago.
Telecagepant: This drug blocks the receptor of calcitonin gene-related peptide (CGRP), a substance that’s released during migraines. Doctors often prescribe triptans to deal with CGRP, but some people can’t take them. Telecagepant is about a year away from receiving approval.
Transcranial Magnetic Stimulation (TMS): Used as a depression treatment, this technique may work on headaches, too. A device would deliver a powerful—but painless—electromagnetic pulse to zap headache-related electrical activity in your head.
This article was first published in Health magazine, May 2009.