OUR ADVICES – Rest, darkness, and above all treatment to be taken as soon as possible. Take it with you wherever you go.
A new migraine attack is coming. You know it, you know it this pain which gradually gains your brain and will not let you go for several days if you do nothing. Often intense, it usually prevents you from carrying out your daily activities. We will have to isolate ourselves, hold on until it passes…
And yet, these pains are not inevitable, they can be quickly and effectively relieved. “There is no reason to remain passive, grit your teeth and wait,” insists Solène de Gaalon, neurologist at the Nantes University Hospital.
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severe crisis
In the event of a moderate crisis or in the absence of treatment available, certain measures help to relieve the pain: calm down in the dark and rest because the pain is increased by movement. “In children especially, sleeping is usually enough to make the pain pass”, says Solène de Gaalon. Better can also be obtained by applying a hot or cold source to the painful area. Finally, take a large cup of coffee because caffeine is a vasoconstrictor and opposes the cerebral vasodilatation causing the crisis.
However, in the event of a severe attack, it is necessary to take appropriate medication to shorten it and resume daily activities. “The earlier it is taken, the more effective it will be. Ideally within an hour of the onset of the crisis,” says the neurologist. This implies for people with migraines to always have their treatment with them when traveling or on vacation. “The patient can expect total relief with a dose or two, if they respond well,” says Solène de Gaalon. Sometimes it is necessary to try several treatments before finding the right one.
It will then be effective on the following attacks but not necessarily on all of them because “they don’t always look alike”, adds the neurologist. First, it is recommended to test a non-steroidal anti-inflammatory drug or NSAID (ibuprofen, ketoprofen, naproxen or diclofenac) knowing that ketoprofen and ibuprofen have specific indications in the treatment of migraine with or without aura. Take a first tablet when symptoms appear, then a second within six hours if the pain persists. Paracetamol can be effective in mild attacks, but generally does less well than NSAIDs in migraine. However, it is the first-line treatment for pregnant women.
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In the absence of effectiveness of these treatments, it is necessary to consult because prescription drugs called triptans offer superior effectiveness. There are several that have differences in tolerance and effectiveness from one patient to another. If one is not effective following being tried on at least three attacks, it is recommended to try another. The triptan should be taken as soon as the pain appears. If the latter returns, a second tablet can be taken two hours later and should theoretically put an end to the pain. If it’s not the case, “Talk to your doctor once more until you find the right ‘cocktail'”, concludes Solène de Gaalon.
