The first step in treating migraines is to identify the triggering factor. Food allergies are the most common triggers, but many other factors contribute. It is important not to overlook the role overuse of medications may play in chronic headaches. Some estimates are that up to 70% of chronic daily headaches are drug induced. Ask your pharmacist if medication you are taking can cause headaches. Two main categories of drug-induced headaches are due to daily use of over-the-counter analgesics (pain medications) such as Tylenol, aspirin, or ibuprofen. Another common cause is the overuse of ergotamine, commonly used to treat migraines.

In the early 1980's it was reported that heavy analgesic users experienced more headaches of greater intensity than the general population. Migraine sufferers who took more than 30 analgesic tablets per month had twice as many headaches as those who took less than 30. In one study, 70 patients taking 14 or more analgesic tablets per week were asked to discontinue their use. Sixty-one percent of them reported improvement in headache frequency after one month; after two months, eighty-one percent reported improvement. Regular use of ergotamine is associated with a dependency syndrome characterized by chronic headache which increases in intensity upon stopping medication. Migraines rarely occur more than once or twice a week, daily headaches by someone taking ergotamine is a strong indicator of ergotamine rebound headache. Persons taking more than 10 mg per week of ergotamine are likely to suffer from rebound headaches. Stopping ergotamine causes intense headache usually accompanied by nausea and vomiting. These headaches usually occur within 72 hours and may last another 72 hours but improvement after going off medication is common.

Food allergies that cause the release of histamine can play a major role in migraines. Foods that are high in histamine-like compounds such as chocolate, cheese, beer and wine are common triggers, but any food to which a sensitivity is present may also trigger headache. Nutritional supplements may help with food allergy triggers. Vitamin B6 can help increase diamine oxidase, an enzyme necessary to break down histamine. 5-HTP increases serotonin and endorphin levels to help prevent migraines. Doses between 200 mg and 600 mg daily have been shown to be as effective as some prescription medications. Essential fatty acids such as found in flax seed oil can help decrease platelet aggregation and prevent the migraine cascade. Small studies using high-dose riboflavin have shown effectiveness in prevention. Magnesium deficiency can trigger increase frequency of migraines, supplementation of magnesium in those persons with a deficiency may help reduce headache frequency.

AT TAOS PHARMACY WE PROVIDE UP-TO-DATE INFORMATION TO HELP YOU WITH YOUR HEALTH CARE DECISIONS. ASK US FOR A COMPREHENSIVE DRUG USE REVIEW. WE MAY BE ABLE TO HELP YOU WITH DIETARY AND NUTRITIONAL RECOMMENDATIONS TO COMPLEMENT YOUR DRUG THERAPY.

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