Migraine is a genetic neurologic disease in which pain is only one possible component. Migraine attacks without pain are called acephalgic Migraines.
Because Migraine is very individualized among patients, so is treatment. Headache specialists recommend an abortive medicine to stop the Migraine process. DHE and triptans are two classes of medicine that abort Migraines.
Pain medicine and medications that work on pain receptors often are the cause of Migraineurs becoming affected by another condition called Medication Overuse Headache (MOH) also known as rebound. Unfortunately, DHE, triptans, butalbital, tylenol, NSAIDs, opioids (narcotics) and many other medicines can also cause the changes in the brain that result in MOH.
Additionally, these medicines are known to be a part of the transition from episodic Migraine (occasional attacks) to chronic Migraine (headache 15 or more days per month). Certain members of this group of medicines such as butalbital and acetaminophen are known for being especially bad at causing MOH and transformation from episodic to chronic Migraine and should be avoided.
Stress has been removed by the International Headache Society as a trigger for Migraine.
Butalbital, is very effective in combination with asperin or tylenol, especially for migraines caused by stress.
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