Effective migraine options in Australia

Over 20% of the Australian population live with migraine disorder¹. Of this group, 400,000 face chronic migraine, meaning they experience migraine symptoms for 15 or more days each month.¹

This condition profoundly impacts day-to-day living. Moreover, without a treatment plan in place, migraine sufferers may have an increased risk of experiencing more threatening symptoms.

That’s why it’s important for those experiencing migraine to be aware of the treatment options and how they can gain access to them. Read on as we cover acute vs. preventative medications, holistic prevention and management strategies, and the next steps you can take if you’re suffering from migraine.

Migraine treatments: Acute medications vs preventative medications

If you believe your condition may need medical intervention, touch base with your GP or with one of the MedReleaf Clinic doctors. While acute and preventive medications both include over-the-counter options, you need to ensure that you receive the right treatment based on your specific medical history and condition.

Acute medications

Acute migraine medications are administered at the onset of a migraine to alleviate its symptoms.

A range of options is available for the acute management of migraine disorder, but not all treatments are effective for every patient. The choice of the most appropriate medication depends on the migraine’s severity and any concurrent health conditions or medications.

There are first-line acute medication treatments and second-line treatments:

• First-line treatments are typically recommended by GPs as the initial approach to managing acute migraine symptoms. These treatments are generally preferred because they often offer effective relief with minimal side effects.
• Second-line treatments are considered when first-line medications are ineffective, not tolerated, or contraindicated due to other health conditions. These options are often more specialised and may target fewer symptoms or have a more complex method of administration. Second-line treatments are chosen based on a comprehensive evaluation of the patient’s response to other medications and their overall management plan for migraine.

Preventative medications

Preventive medications work to reduce the frequency, severity, and duration of migraine attacks. These medications are typically used by those who experience frequent or particularly debilitating migraine episodes.

The goal of preventive treatment is not to cure migraine but to decrease their impact on the patient’s life by making them less frequent and intense.

Here are four key points on preventative medications:

1. Weighing benefits and risks: Your GP will assess both the advantages and potential negative reactions of the medication. The evaluation goes beyond the number of migraine days to include side effects, lifestyle compatibility, and emotional responses to such medications.
2. Cumulative advantages: Over time, patients often report a decrease in the frequency of migraine days with continued medication use. Regrettably, many discontinue their treatment prematurely, missing out on these potential benefits.
3. Dose dependency: Increasing the dosage of preventive medication usually enhances its effectiveness in reducing migraine days, though this also escalates the likelihood of side effects.
4. Concerns over side effects: While preventive medications can have side effects, medical professionals and researchers invest extensive research into these interventions. Based on an individual’s health background and existing conditions, doctors can guide patients away from unsuitable treatments.

Types of acute medications

You can view a full list of acute treatment medications and their associated brands, formulations, and dosing on Migraine & Headache Australia’s website. While this information is helpful in providing you with a sense and overview of the available treatments, ensure your GP is your first port-of-call for advice and plans tailored to your specific health needs and migraine management.

Over-the-counter acute treatment options include:

• Aspirin: Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing substances in the body that cause pain and inflammation. Beyond pain relief, it’s often used to treat migraine due to how it may alleviate associated symptoms.
• Ibuprofen: Ibuprofen helps by inhibiting the body’s production of inflammation-causing chemicals called prostaglandins. In doing so, it can reduce both the pain and inflammation that are part of a migraine attack.
• Paracetamol: Paracetamol, also known as acetaminophen, is used for the relief of both pain and fever. It’s often used when someone seeks a treatment option with fewer side effects or when NSAIDs are contraindicated.

Types of preventative medication

Similar to acute medications, preventative medications include a combination of prescription and over-the-counter options. A full list of preventative medications can be found on Migraine & Headache Australia’s website.

The over-the-counter options include:

• Natural remedies: As a part of the wider treatment plan, GPs may recommend that patients consume Magnesium, Vitamin B2, and other vitamins that are known to help reduce the frequency and severity of migraine attacks.
• Neurostimulation devices: While many neurostimulation devices are available to the public, ensure that you speak with your GP or a MedReleaf Clinics doctor before trying one. These devices include Cefaly, which stimulates the supraorbital nerves above the eyes to reduce migraine frequency and severity, and GammaCore, which targets the vagus nerve in the neck to manage both migraine and cluster headaches. Both are designed to reduce migraine frequency and severity through nerve stimulation.

Personal migraine management strategies

There is no known cure-all for migraine. GPs will typically create individualised treatment plans that may include both preventive and acute treatment options, along with lifestyle adjustments and complementary therapies, to reduce the severity.

Understanding triggers

Noticing migraine triggers and working to reduce your exposure to them is a practical prevention step. Common triggers include:

• Emotional states: Stress is notably the most prevalent emotional catalyst for migraine. Additionally, conflicts and high excitement levels may precipitate an attack.
• Sleep patterns: Both insufficient sleep and excessive sleep can act as triggers.
• Dietary habits: Skipping meals, delays in eating, or insufficient food intake can initiate migraine, as can specific foods like chocolate, citrus fruits, aged cheeses and meats, cultured products, and many processed items.
• Food additives: Substances such as caffeine (commonly found in coffee), monosodium glutamate (MSG), and aspartame are known triggers.
• Alcohol consumption: Wine often triggers migraine, though some beers and spirits can also have this effect.
• Sensory stimuli: Exposure to intense or flickering lights, strong odours (such as gasoline or perfume), and loud or sudden noises can trigger migraine.
• Environmental changes: Factors like travel, changes in altitude, and shifts in weather (especially barometric pressure changes) can provoke migraine.
• Screen exposure: Excessive or improper use of digital devices, poor posture during screen time, movie theatres, and video watching can all be triggers.

Beyond these triggers, note that your migraine attacks may also be linked to other health conditions and physiological states, including hormonal fluctuations, cardiovascular diseases, mental health disorders, and other systemic conditions that can exacerbate or trigger episodes.

Hormonal fluctuations: Changes related to menstrual cycles, pregnancy, menopause, or hormonal medications can provoke migraine. Oestrogen fluctuations are particularly noted for their impact on migraine patterns, as they can influence the chemicals in the brain that are associated with migraine pain. Data suggests that migraine may be more frequent and severe during periods when oestrogen levels drop, such as just before menstruation or during the postpartum period.

Cardiovascular issues: Research indicates a bidirectional relationship between migraine, especially those with aura, and cardiovascular disorders such as stroke and heart attacks. A bidirectional relationship refers to migraine increasing the risk of cardiovascular disorders, and vice versa. Moverover, migraine sufferers have a higher risk of having angina and other ischemic cardiovascular diseases.

Mental Health Disorders: The link between migraine and mental health issues such as anxiety and depression is well-established: Those with migraine are up to three times more likely to suffer from these conditions. The relationship is thought to be bidirectional, with the stress and dysfunction from these mental health disorders potentially triggering migraine, and the recurrent pain and disability of migraine exacerbating mental health symptoms.

Systemic Conditions: Migraine is also commonly comorbid with respiratory conditions like asthma and allergies, which suggests an inflammatory component shared across these conditions. Additionally, neurological conditions, such as epilepsy, share common genetic and pathophysiological links with migraine, indicating a broader neurobiological basis that could trigger or worsen migraine symptoms.

Your GP will guide you through what is likely causing your migraine — whether it’s linked to another condition, trigger, or not.

Effective natural migraine therapies

As a part of your wider treatment plan, your GP may recommend one or more of the following natural therapies:

• Acupuncture: Effective in relieving migraine pain by stimulating specific points in the body to release endorphins, the body’s natural painkillers.
• Biofeedback: Helps patients learn to control physiological functions such as muscle tension and heart rate, which can reduce the severity and frequency of migraine.
• Massage: Reduces muscle tension, particularly in the neck and shoulders, which can help prevent or alleviate migraine.
• Meditation: Reduces stress, a common trigger for migraine, and can lower the frequency and intensity of migraine attacks.

They may also recommend aromatherapy, hypnotherapy, physiotherapy, hydrotherapy, or another intervention, depending on the specifics of your condition.

MedReleaf Clinics can help

If you suffer from migraine, the first step is to speak to a doctor.

At MedReleaf Clinics, our doctors specialise in migraine treatment interventions. We’ll comprehensively cover your medical history, assess your condition, and place you on a tailored treatment plan. Our doctors are holistically focused, meaning we consider all possible causes behind your migraine to ensure optimal quality of life.

To discuss your health concerns and gain answers to any questions, start by booking a free pre-screening call.

Reference list

1. Migraine Australia. (n.d.). Burden of Migraine. https://www.migraine.org.au/burden.