Migraine or “pain on one side of the head” is a chronic neurological disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous system symptoms. Migraine ranks in the top 20 of the world’s most disabling medical illnesses with more than 10 percent of the population suffering from migraine, many of which are reoccurring.
Typically the headache affects one half of the head, is pulsating in nature, and lasts from 2 to 72 hours. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur. Occasionally an aura can occur with little or no headache following it.
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Ketamine is an NMDA receptor antagonist and works in a number of different ways in the brain. Studies have shown it to be beneﬁcial in treating neuropathic pain including that related to migraine, speciﬁcally the aura that is associated with an acute attack.
Flurbiprofen is an anti-inﬂammatory agent. This class of drugs have been used successfully in migraine treatment. They act to alleviate neurogenic inﬂammation and block prostanoid receptors to limit the inﬂammatory pain response.
Gabapentin and Amitrityline are frequently used to aid in the prevention of migraine. Use in an acute attack may help prevent the attack from returning as well as help decrease the severity of symptoms.
Ondansetron is used to treat the nausea and vomiting that is often associated with migraine attack.
Topical preparations effectively treat pain at the source with limited systemic absorption which can improve patient adherence and decrease dependence on oral medications while maximizing therapeutic outcomes. One Stop Rx can provide a migraine transdermal pain cream product that can be individualized to fit a patient’s needs.