Lhe migraine is an invisible disease that poisons the daily lives of those who suffer from it, but it is possible to reduce the pain by resorting to the right gestures from the start of the crisis. When the first symptoms appear, it is recommended to drink water and, when possible, to lie down quietly in a dark environment. In addition, certain treatments can make it possible to reduce the intensity of the attacks and to space them out.
There is no cure to permanently get rid of migraines. In first intention, the attending physician therefore prescribes so-called non-specific care, consisting of analgesics and anti-inflammatories. “If these drugs are not enough, the doctor will prescribe more specific migraine attack treatments called triptans. They make it possible in particular to reduce the dilation of the blood vessels of the brain during the crisis”, underlines the Dr Sylvain Redon from Pain Assessment and Treatment Center – La Timone Hospital, in Marseille. Objective ? Eliminate the crisis in less than two hours and limit its severity. For this, the drug should be taken as soon as possible. Triptans are often very well tolerated, but they sometimes cause certain transient side effects, such as fatigue, a feeling of heat or difficulty concentrating.
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As Inserm reminds us, it is imperative not to exceed eight days per month of crisis treatment, to avoid headaches this time caused by overconsumption of drugs. “If the frequency of seizures is excessive, or if the seizures do not respond well enough to these drugs, disease-modifying therapy may be indicated. By regularly observing a preventive treatment, we manage to reduce the number of crises by at least 50%, ”assures the Dr Sylvain Reddon. These background treatments, prescribed by the general practitioner or neurologist, may be non-specific for migraine, for example beta-blockers, antidepressants, antihypertensives or antiepileptics.
Le neuropeptide CGRP
Some patients sometimes resort to injections of botulinum toxin type A into various muscles of the skull and face. Since July 2021, this treatment has had a marketing authorization extension. There are also specific treatments for migraine, such as specific monoclonal antibodies against the neuropeptide CGRP. “Some of these drugs are already on the market, but they are expensive and, for the moment, not reimbursed in France. They are indicated for patients who suffer from at least eight days of migraine per month and who have reported failure with two disease-modifying treatments,” explains the neurologist from Marseille. Before concluding: “These are interesting alternatives in patients who have poorly tolerated or who have not responded to non-specific background treatments for migraine. Clinical trials have shown that these treatments are often well tolerated, both in the short and long term. »
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