TREATMENT OF MIGRAINE’S ACUTE ATTACK: PAIN KILLERS (ANALGESICS)

Although it seems obvious that one of the best treatments for headache should be a pain-killer, different drugs have different mechanisms of stopping the pain. The most commonly used pain-killers, such as aspirin and paracetamol (Panadol), act mainly peripherally but also have some central actions on the brain, inhibiting the perception of pain. Another of their central actions is to act on the temperature regulatory mechanism and so reduce fever.
If taken early enough, many people find that aspirin or paracetamol will abolish an attack. Because absorption during a migraine attack is variable, it is better to take a soluble or effervescent form of these drugs, particularly in those prone to stomach problems, since ulcers are more likely to be aggravated by insoluble aspirin tablets.
Stronger analgesics act directly on the brain, by affecting the endorphin receptors and making the brain less responsive to pain; they often cause drowsiness or euphoria, and sometimes nausea. Most of these drugs are derivatives of opium and include pentazocine (Fortral), distalgesic, codeine, dihydrocodeine (DF 118), pethidine, diconal, morphine, and heroin. The last two should never be used in migraine but many people find codeine useful.
Most useful in attacks is a soluble combination of panadol and codeine (Paracodal, Solpadeine, etc.). This is the painkiller of choice used in acute migraine clinics where 80 per cent of patients feel better within two hours.

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PAIN RELIEF/ MUSCLE RELAXERS