Therapy, prevention

How migraines are treated today

There is help for unbearable headaches.

(Bild: Stasique_Photography/stock.adobe.com)

Depending on how severe the agonizing attacks are, special forms of therapy are available today. If they occur frequently, preventative preparations can also be used to significantly reduce the number of attacks. 

Migraine is a headache disorder which, if not treated properly, is associated with a 10-fold increased risk of developing depression or anxiety disorders. It is therefore essential to seek help!

"Today, we are able to improve the quality of life of our patients enormously. GPs, specialists and therapists need to work together," emphasizes Dr. Sonja-Maria Tesar, neurologist and general practitioner in Klagenfurt. "But patients themselves are also called upon to seek medical help and not accept their illness. They themselves know their seizures and their best possible drug treatment and ideally also take non-drug measures seriously."

New drugs for pain therapy
In addition to acetyl acid, ibuprofen and paracetamol, so-called triptans are also available for the acute treatment of migraines. For migraines with aura, these should only be taken after the aura has subsided. Lasmiditan has been approved in Austria since August 2022. It belongs to the Ditane substance group and is particularly suitable for patients who have a high cardiovascular risk, as Lasmiditan does not constrict the blood vessels, unlike triptans, for example. However, patients must pay for this medication themselves.

Prevention and acute treatment
"Rimegepant, from the active substance group of Gepante, has been approved by the EMA, the European Medicines Agency, since April 2022 as the first migraine medication that can be used both in acute therapy and prophylaxis," explains Dr. Tesar. "Previous results have shown good tolerability and safety; long-term data are still lacking. The starting point of the effect is the so-called CGRP receptor, which is already used as a reference point for CGRP antibody therapy." Since January 2024, this medication has only been reimbursable in Austria after obtaining approval from a chief medical officer.

Prophylaxis reduces attack days
The aim of migraine prophylaxis is to reduce the frequency of migraine days and thus significantly improve quality of life. Prevention is considered successful if the monthly migraine days are at least halved in the episodic form or reduced by at least 30% in the chronic form.

For some years now, so-called monoclonal antibodies have also been available for the prevention of chronic and episodic migraines (at least 4 days/month).

What sufferers can do themselves
It should not be forgotten that non-pharmacological methods such as behavioral therapy, relaxation techniques, endurance sports and generally adhering to lifestyle measures can also help to improve the condition and thus preventively reduce the number of migraine days.