Migraine Remedies

Migraine Remedies
VITAMINS/SUPPLEMENTS
• Tri-Magnesium citrate: effective but must be 600mg 1/daily, not lower twice daily.
Take also with calcium, and calcium should be no more than double the amount of
magnesium, and ideally 1:1. Maybe try 400mg?
• Vitamin D alone doesn’t help. But, “studies have shown that when calcium is
administered along with Vitamin D, it reduces the frequency of migraines in a
considerable number of patients.” 50,000 IU per WEEK (D2). Watch for Vit D
toxicity however.
• Feverfew: 100mg/day.
• Butterbur: 75mg/day. Make sure it doesn't include pyrrolizidine alkaloids.
• Vitamin B2 (riboflavin): 50-400 mg a day. Some controversy as to whether there is
a benefit of 400 over lower. Should probably start with lower dose and increase if
not effective.
• Folic acid (b9): 2-5mg (use the active form if you have the MTHFR gene
mutation).
• B6: 25mg
• Melatonin 3mg/day shown in a study to help. Results were progressive over 3
months. I wonder this can be taken with L-Triptophan, though, since both are
precursors to triptans (watch for excessive serotonin).
• 400microg, vitamin B12. Problem is that B12 orally raises serum cobalamin
concentration much less than in the nose or as a shot. As a shot may technically be
best option, like 1,000 microG once per week.
• Vitamin E: 400IU. Study shows that it helps prevent rebound headaches caused by
triptans. Take at the same time you take a triptan and for 2-3 days afterwards.
• Vitamin C: theoretical papers suggest that it could help. However, there have been
no studies proving or disproving that theory other than some case studies.
• CoQ10, 150mg per day (range: 60-300).
• Niacinamide, 500-1000mg/day (theoretical only, not supported by studies).
• Niacin, 375mg 1x day (based on case study, may work because of vaso effects.
• Precursors to seratonin (that’s why triptans work). L-Tryptophan, 2-3g per day,
some small studies shows it’s effective. But warning that if you add triptans then
levels may be so high that become toxic. So don’t take with triptans, or take in
lower dose like 0.5-1g per day, and watch for serotonin syndrome. L-Tryptophan is
an essential amino acid important in human nutrition for the synthesis of melatonin
and serotonin, hormones regulating sleep, positive mood and immune function.
• Fish oil 6-15g per day. May be effective. Some studies showed placebo worked
really well but the placebo was olive oil which also includes anti-inflammatory
properties.
ACE INHIBITORS
• Candesartan is medium effective in reducing number of headache days, and
severity.
• Lisinopril: similar results.
• Telmisartan doesn’t work.
ANTIEPILECTICS
• Divalproex, 500-1000/day. Works, 4.4 to 3.2 headaches per week, but side effects
problematic.
• Gabapentin, titrate over 4 weeks to 2400 per day, significant reduction in migraine
days
• Lamotrigine is not effective
• Oxcarbazepine is not effective
• Topiramate (topamax) is effective. Study compared Topamax 50mg/day to
propranolol (beta block) 80mg/day. Some similarities, but overall Topamax was a
bit more effective than propranolol. Topiramate is also fairly comparable in
efficacy to sodium valproate (400mg/day). Topiramate can go to 100-200mg/day,
and pronalolol 160mg/day.
ANTIDEPRESSANTS
• Fluoxetine: 20mg/day. Arguably works, but need more study and not all studies
consistent.
• Venlafaxine XR 150, definitely effective, and twice as much as the 75.
• Tricyclic antidepressants, like amitriptyline, probably work as good as venlafaxine,
but need more studies to confirm.
BETA BLOCKERS
• Metroprolol 200mg per day (one study suggests it reduces migraine frequency by
50%)
• Propranolol 80mg/day
CALCIUM CHANNEL BLOCKERS
• Flunarizine (5-10 mg/day, to treat patients with prolonged aura)
• Verapamil (240–360 mg)
OTHER RX Botox is effective, at least 150 units. But doesn’t work for everyone.
OTHER OTC
• Cromolyn sodium shown in a small study to completely prevent migraines for
people who ate foods to which they know they had a migraine-inducing food
allergy. Try to pop one of these whenever eating food that may be a trigger (but
doesn’t this pill have to be taken for a month in order to be effective on mast cells?
- may need to research further)
• Antihistamines are effective in a subset of migraine patients. Research this a bit
further.
DIET ISSUES
• High protein, low carb diet
• Any glucose issue (pre diabetic, etc.?). Or, do symptoms typically start in late
morning or late afternoon (when glucose levels at the lowest)? For such people,
having six meals per day and no refined sugars reduces migraines.
• Consider cutting caffeine? Both helps and hurts.
• Study shows that sudden salt load, esp. on an empty stomach (e.g., eating a salty
snack) can cause migraine 6-12 hours later. Best to avoid sudden salt loads.
• Do not fast, ever
• There is a study that shows that a food elimination diet that is specifically based on
IgC antibodies does help in reducing the number of headaches.
• Overall, dieting and avoiding certain food helps in alleviating frequency and
intensity, but doesn’t work as a complete cure.
• Food allergies
There are actually two types of food-induced migraines. One would be actual
allergy to that food, and the other isn’t related to allergies but do trigger migraines,
for example because the good has vasoactive substances, inc. tyramine,
phenylethylamine, possibly histamine and phenolic compounds.
Patients with migraines associated with a known food trigger had significantly
lower platelet PST-P activity and nonsignificantly lower PST-M activity,
compared with healthy controls and with migraine patients who had no known
dietary triggers. Similarly, those sensitive to chocolate had significantly lower
platelet monoamine oxidase activity. In theory this means that could diagnose part
of food allergy by testing for PST activity? Can proper PST activity be chemically
restored? Epson salts are supposed to help. 30 min foot bath. See other notes about
Epson salts.
Overall, studies show that food allergies do play an important role in migraines and
that cutting certain foods can help, though for most patients the relief is partial and
not complete.
*No aspartame.
ACUTE THERAPY (to treat active migraines)
**Short term triptans**

• Almotriptan, 12.5mg to be effective. 25mg same effectiveness but more adverse
events.
• Eletriptan, 40mg or 80mg. Slightly less effective than Almo.
• Rizatriptan 10mg. effectiveness 74% relief, 42% free
• Sumatriptan 50-100mg, 66.2% 2 hours hedache free. Injection, 70%. Intranasal
with new bidirectional powder delivery device, 10mg is enough, called OptiNose
and as effective as injection.
• Zolmitriptan, nasal spray better than pill, but even then not all that effectiveLong-
term triptans
• Frovatriptan, 2.5mg. , up to 68% at 4 hours, but only 48% at 2 hours. Because it is
so long acting, Frova isn’t as good to stop a migraine in its track short-term as
other types of triptan
• Naratriptan 2.5mg (not a lot of studies)Other triptan
• Sumatriptan/Naproxen Sodium (Treximet), much more effective than Sumatriptan
alone. 85mg/500mg,
• Frova mixed with a NSAID, in that case dexketoprofen (Keral?) 37.5 mg, also
showed to be much more effective than Frova alone both at onset as well as later.
Other Rx
• Prochlorperazine suppository, showed to be very effective for acute attack.
• DHE, breath-syncronized inhaler. Use 0.5mg NOT 1.0mg which is LESS effective.
Used for severe headaches (not outset only). Effective against placebo, but overall
sucess not very high.
• Chlorpromazine, intravenous 0.1mg/kg, in the Emergency Room. 46% relief after
30 minutes, 82% after 60 minutes.
• Droperidol injection. 2.75mg or more. Up to 87% relief!! Sounds strong though.
Stay under 5mg to avoid heart issues (though very rare)
• Phenazone, 1000mg, average effectiveness.
• Diclofenac-potassium, 50mg, very comparable to sumatriptan in effectiveness, but
with less side-effects and other corollary benefits over the triptan drug. The sachet
is slightly better than the tablet.
• Tramadol/Acetaminphne 75mg/650mg. Somewhat effective, 55.8% 2 hour relief.
• Currently doing research on oral CGRP antagonists, appears to have promiseOther
RX (injectable, many are ER only)
• Ketorolac tromethamine with 6% lidocaine: some 2-hour improvement over
placebo, but not great.
• Tramadol: in emergency room, 100mg IV, 76% headache relief (but not freedom)
• Magnesium Sulfate in ER, 1g in a 10% solution. Seems one of the most effective
as well, but there are mild side effects such as burning sensation in face and neck,
and decrease in systolic blood pressure. This does not work nearly as well on
migraines without and aura.
• Intravenous valproate, IV, 63.1% improvement, 300-1200mg.
• Look at study re ER treatment of migraines, some of the drugs can be administered
IM. Possible to keep backup at home and give her a shot in arm or butt instead of
ER visit? For example, Ketorolac 60mg IM.
• When used for headaches whose duration has not exceeded 6 hours, efficacy of
sumatriptan subcutaneous is 91%! 75% otherwise. Should self-administer too? For
patients who do not respond to triptans, or already took it maybe, NAID mixed
with a phenothiazine are a good option.
• To research further: ”Myers Cocktail” combination of magnesium, calcium, B
vitamins and Vit C in IV. They can do it, as well as probably some others..maybe
tee them up for emergencies? http://www.biorient.com/ http://ivforlife.com/ Here
is a recipe as well, they say compounding pharmacies will know which Drs
prescribe it: http://migraine.com/blog/migraine-treatment-intravenous-
micronutrient-therapy-ivmt/ Also helps people with firbomyalgia. Generally called
IV Infusion Therapy. Research this further, or just try it out once during an attack
(I live in Orange County, sorry for the local references).Do not take:
• Octreotide. Makes it worse.OTC
• Acetaminophen (Tylenol) 1000mg, ineffective against moderate, effective against
severe (wtf?).But works better when mixed with aspirin and even caffeine
(basically, that’s excedrin)
• Ibuprofen (Advil) 200mg for moderate migraine, but 400mg for severe migraine.
• Aspirin: 900mg mouth-dispersible formulation. Not bad for an OTC.
Note: Excedrin extra strength is: 250 acet, 250 aspirin, 65mg caffeine (1 cup coffee
is a bit above 100mg)
• One practicioner reports using oral niacin 300-500 mg (chewed slightly) at the
onset of an aura.
• Naproxen sodium, see above re taken at same time as somatriptan. Should
probably take every single time since not as concerned about rebound, i think. 500-
550mg at onset of attack.[studies with comparisons of triptans?][add hormonal
treatments (birth control included)]OPIOIDS
• Butorphanol nasal spray 1mg - shown as effective
• Other opiods (vicodin, morphine, oxy, methadone) effective for some patients, but
their use can be controversial in the medical community.
Not enough water

Too much light
Stress
strong negative emotions
Weather changes
Barometric pressure changes
Seasonal changes
Sudden storms
Eating certain foods
strong smells
improper sleep
loud noise
heat
alcohol
glasses
https://www.youtube.com/watch?v=Ww7wBZJ1D28
20 Highly Effective Migraine Relief Remedies in 2022
https://www.axonoptics.com/migraine-relief/
Prodome
postdrome
blue light glasses

Exercise
caffeine + analgesics
neti pot
Avoid migraine foods
tryptophan and
ginger
remove dairy, sugar, gluten
probiotics
nurtec
topamax
emgality
topiramate
adderal
aimovig
botox
amytriptaline
elavil
nortriptyline
ajovy
ubrevly
propanolol
tizanidine
sumatriptan
naratriptan
zolmitriptan
rizatriptan
floricet
eletriptan
diclofenac
metoclopramide - nausea
ondansetron
Intravenous Chlorpromazine
Dihydroergotamine infusions
Nortriptyline 50mg (started at 10mg)
heating pad on feet
Imitrex

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Migraine Remedies

Short term triptans

Not enough water

blue light glasses

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