Remedies for migraine attacks with severe disability

In the acute treatment of severe migraine attacks, different situations can be distinguished:

  • General measures
  • Announcement symptoms of a migraine
  • Treatment of migraine attack
  • Emergency treatment for migraines by the doctor
  • Actions if the migraine attack lasts longer than three days

General measures

As with mild migraine attacks, if possible, you should immediately retreat to a quiet, dark room and try to relax.

Announcement symptoms

Many migraine sufferers are familiar with the symptoms of a migraine attack. Such symptoms can be, for example:

  • Mood swings in the sense of irritability
  • Particularly great enthusiasm
  • Hyperactivity and great motivation
  • excessively good atmosphere
  • increased appetite, especially for sweets
  • pronounced yawning
  • Dejection

Such warning symptoms appear in over a third of migraine patients up to 24 hours before the onset of the migraine attack. If you suspect that a migraine attack is imminent based on the symptoms, you should now try to counteract it with behavioral health measures.

These can be: relaxation techniques, taking additional breaks, bringing regularity to the day, an extra bag of readily available magnesium citrate, going to bed on time, eating a small carbohydrate-rich snack before bed to moderate the drop in blood sugar during the night, getting as much rest as possible stick to it as much as possible and try to avoid avoidable triggers.

If the migraine attacks occur with great regularity in connection with menstruation, you can do the same 24 hours before the expected menstruation.

Treatment of migraine attack with severe disability

A severe migraine attack occurs when the treatment regimen initially used for mild migraine attacks as part of self-medication (see last chapter) does not prove to be sufficiently effective. Severe migraine attacks also occur when pronounced individual aura symptoms or combinations of several aura symptoms occur at the beginning. Severe disability is also manifested by long and frequent attacks, frequent and long inability to work or inability to participate in social life.

Severe migraine attacks are very successful today

  • selective 5-HT agonists, the triptans.

Ergotamine – no longer up to date

Ergotamines (ergot alkaloids) were the only option for the targeted treatment of severe migraine attacks until 1993. They are available in the form of tablets, suppositories and aerosol spray for inhalation. However, ergotamines are no longer used in modern migraine therapy, as frequent use of ergotamines can very quickly worsen the frequency and intensity of migraine attacks! It can all too easily result in a constant, daily headache – the drug-induced permanent headache mentioned above. In addition, after stopping ergotamine, a so-called withdrawal headache occurs. Those affected therefore have to continue taking more and more ergotamine over time in order to avoid withdrawal headaches.

With long-term therapy, severe circulatory problems can also occur in a wide variety of body organs, usually initially in the arms and legs. The circulatory problems can have very serious consequences, including fatal heart attacks. Organs can also die or fistulas can form in various organs. Ergotamines can also very often cause nausea and vomiting. The effectiveness of treating migraines is also very weak. For all of these reasons, ergotamines are now only used for attack therapy in rare, exceptional cases.