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Preventing Migraines in Teenager

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Q. My 13-year-old daughter suffers from migraines, sometimes lasting for five days. The neurologist has controlled them up to now with ibuprofen and a caffeinated soda, but that is no longer working.

They want to put her on an anti-epilepsy drug, but that makes me uncomfortable. Is there anything more natural?

I have a hard time with pharmaceuticals that I think are being tested on the public, but as a mother I would do just about anything to stop her pain! I look forward to any information you can send me.

A. We appreciate your concerns since there can be side effects with anti-epilepsy medications. Your daughter should see a headache specialist, preferably one with experience treating teens.

Biofeedback is a safe and potentially helpful approach (Cleveland Clinic Journal of Medicine, Suppl. 3, July, 2010). Other ways to prevent migraines without drugs include acupuncture, magnesium, Coenzyme Q10, riboflavin, and herbs such as feverfew and butterbur. To facilitate a discussion with her doctor, we are sending you our Guide to Headaches and Migraines. It contains information on the pros and cons of drugs and details about other treatments.

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Lyn Griffiths, director of Griffith University's Genomics Research Centre on the Gold Coast, is doing research on migraines in Australia.

Professor Griffiths has been hunting migraine genes for more than a decade and so far she has identified three kinds, corresponding to disturbances in neurotransmitters, hormones and blood vessels. However, there are likely to be many more migraine genes, accounting for the many variations, such as differences in triggers for attacks and response to medication. In the future, a genetic test may be able to identify which kind of migraine a patient has, so treatment could be tailored to that, she says.

For those with migraines related to blood vessel health, this time has already come. That's because Griffiths has shown impressive results in a trial of vitamin supplements, published last year.

People with this type of migraine (about 20 per cent of patients) have high levels of homocysteine, an amino acid, which causes problems in the lining of their blood vessels.

Daily doses of 2mg of folic acid, 25mg of vitamin B6 and 400mcg of vitamin B12 reduced homocysteine levels and cut the frequency and severity of migraines.

I suffered from migraines from a very early age. They became so bad that my Doctor used to give me an injection to knock me out. However, when they started lasting for 4/5 days I decided to try something new. I went to a naturopath. He took me off all red meat, oranges and I can't remember what else. I then had a migraine that lasted for 10 days. Since then, and this was quite a few years ago, I haven't had another headache. I can eat soya meat but I prefer to stick to chicken and fish.

I suffer from migraines too, but have just recently began to realize that they are caused by onions. Any time I eat even something with onion powder in it (many snack foods contain this), I wake up the next morning with a migraine. Have you considered this?

I sincerely feel for your daughter. I too have had migraines since I was a teenager and have experienced them worse during certain periods of my life rather than others. At my worst, I'd have migraines approximately 2/3 of the month. It's a horrible pain that can be unrelenting.

I found that vigorous, daily exercise helps me more than anything. I assume this is because exercise helps regulate blood flow. A doctor explained that a migraine is caused when a blood vessel is triggered to vacillate (the constriction and dilation is what causes the throbbing). Triggers are different for different people - smells are a strong trigger for me as are certain weather phenomenons (low pressure systems - go figure). When the blood vessel dilates it presses on surrounding brain tissue which causes the pain.

I've been on blood pressure medicine (it helped but I had to go off of it, long story) and currently have a prescription for medication designed for migraine relief (Axert, similar to Imetrex). These drugs work but do have side effects - I try not to take the Axert. My doctor told me to take prescription strength ibuprofen with the Axert because the Axert would stop the vacillation and the ibuprofen would relieve the pain.

Without taking the ibuprofen the existing pain (from the brain tissue) would trigger the blood vessel to start vacillating again. It's a vicious cycle which leads to multiple day migraines.

If your daughter is bothered by accompanying nausea, you might see about an anti-nausea medication. They seem to make the OTC medication work better in addition to relieving the nausea.

I heard on the news yesterday that scientists have discovered a gene linked to migraines. Their goal is to alter the gene to increase a person's pain tolerance. That seems to be addressing the symptom and not the cause but if it works, it's better than what we've got now.

I hope your daughter finds something that allows her to manage her pain. And thank you for seeking treatment for her - also please be patient with her during a migraine, they can cause you not to think clearly.

The parents may want to check & see if her migraines are hormonal. I used to get severe migraines around "that time of the month". If that's the case an ob/gyn can possibly come up with a dose of estrogen to help level her homone levels during her menstrual cycle. It helped me.

I had a lot of migraines and blamed hormones. But once I discovered I couldn't digest wheat or milk and quit eating anything with either in it, the migraines went away. Now, if I accidentally eat something with wheat or milk in it no matter how small, I get a day long migraine the following day.

I also suffered from migraines for years, and nothing I tried worked until my GYN said she thought they might be caused by hormones. She put me on a specific birth control pill to regulate my hormones and it worked. I have never had another one. I know it might sound unconventional for a 13 year old, but at that age it could just be that her hormones are beginning to go wild and may be causing the headaches. Just a thought that you may want to check into, if only to rule it out.

Also, if she is currently on a nasal spay to control her allergies, (such as Flonase) you may want to try something different for awhile and see if they go away. A friend was getting migraines and suspected it might be her nasal spray, as she would get one shortly after using it (that night or even the next day). She switched to a pill form of allergy medicine and her migraines went away.

I also should have added that the only medicine that worked for me when I was getting migraines was Butalbital, which is generic for Fioricet. I hope you find something that works!

My migraine headaches miraculously disappeared once I reached menopause. I now feel that I had been estrogen dominant with ovaries producing low or no progesterone. Perhaps the doctor would allow a trial of a small amount of progesterone cream (rubbed into inner arm) to see if low progesterone could be the cause of your daughter's headaches.

I was diagnosed with migraines about five years ago. This diagnosis was confirmed by several doctors. The migraines were due to hormonal changes which may not be your daughter's problem.

My symptoms were so severe and came almost daily that I nearly had to quit my job. Medications only partially helped. I was desperate, so I started reading every research article I could on migraines. I came across several on a supplement called Migrelief which contains feverfew, riboflavin, and magnesium that was developed by a doctor who works with migraine sufferers.

I was very skeptical about this helping me, but was desperate and started taking it. Reviews I had read said it could take up to 3 months to notice a significant difference, but I began to notice it after two months, my headaches were not as severe and responded to medication quicker. Every month I started seeing more improvement. A year later, I was almost completely off my prescription medicine.

I still get migraines sometimes, but only have to use my prescription meds about 3 or 4 times a year. I still have to be careful of my triggers, but this supplement has made my migraines manageable to the point where I feel like I'm back to a normal life. To be conservative I started with only one pill and that's all I have needed.

I take it at bedtime so that the magnesium does not interfere with my thyroid meds, and I order mine off the internet because it's less expensive. This may not help your daughter, but it's probably cheaper and more natural than prescription meds, so it might be worth trying for a few months before you go to the epilepsy medication. At least research it and see what other users have said about it. Good luck.

I've heard of cyproheptadine which is an older antihistamine being used for preventing migraines.

Anti-seizure meds like Topamax (topiramate) are sometimes used. Although a usually this is prescribed to be taken first 25 mg at a time and then increased slowly to 100 mg/day some do fine with 50 mg/day.

Beta blockers like atenolol and propranolol are blood pressure lowering medications that can be used to prevent migraines.

I, too have suffered from migraines since I was a teenager and I have tried all the triptan drugs out there-they never seemed to work for me (the pain was worse from the side effects of the drug). One thing that did help was to take a magnesium supplement every day, and exercise.

My headaches don't seem to be hormonal, but related to weather an allergies. I was once put on propanolol and that worked best for me! It may be early for your daughter to take a blood pressure medication (I am in my mid-twenties). Another idea, that I found by accident was to eat an icy-pop (the ones in plastic that you just put in the freezer). It seems that when something very cold hits your tongue, it stops that vagal response and the pain subsides.

Magnesium works great as a preventative for me -- I'm 95% free of what were monthly and sometimes bimonthly migraines. When one does begin I take either two packs of BC (powdered aspirin) with a glass of water or a small dose (about .35 mg to .50 mg of sumitriptan - Imitrex generic) within the first hour. No side effects at low dosage.
No more migraine.

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