Migraine Treatment Center
An individual may come to the Migraine Treatment Center to receive outpatient intravenous medications for the aborting of his/her headache and migraine symptoms. Please have a list of all your current medications and dosages when you come for treatment. Also, tell the nurse the names of all medications you have used in the past 24 hours.
Types of Treatment:
Individuals may have a pre-scheduled appointment for a specific treatment. Others may be seen on a urgent basis for treatment of severe migraine symptoms. Space availability may vary from day to day. For most treatments, plan on staying at the Infusion Center for about 6 hours. The nurse may be able to give you an approximate time once the orders for your treatment have been reviewed. Some individuals may be scheduled for 3- 5 consecutive days, and others will receive only a one-day treatment.
Preparing for Treatment:
You may bring a light lunch, snack or beverage. We do have water, some sodas and animal crackers. We try to keep the lighting subdued, and the temperature may be cool , so it is best to dress in layers for comfort. We will need access to your arms for placement of an IV. Please do not wear perfumes, colognes or heavily scented lotions.
Activities during Treatment:
Some individuals prefer to sleep during their infusion. All the chairs in the Infusion Center recline for comfort, and we have blankets and pillows. There is a television, and we do have portable DVD players, so you may bring a movie if you like. Please bring your own headphones.
You must have someone drive you to the Migraine Treatment and Infusion Center
Some of the medications we use may cause drowsiness, so it is important to have a driver to bring you home. If you do not have a driver, please inform the nurse, and medications that may cause drowsiness will be avoided. Your driver may prefer to drop you off in the morning, and we will call them about an hour before you are finished so they can be here to pick you up. If your driver or family member will be staying at the office, they may check on you periodically, but they may not remain in the Infusion Center during the entire time of your infusion. This is for the comfort and privacy of other individuals receiving treatment.
Leaving the Treatment Center:
You will be given instructions regarding care at home after your infusions. If you will be coming in for more than 1 day of treatment, you may choose to cap your IV and leave it in overnight for use the next day.
Medications used in the Migraine Treatment
There are many different medications that can be used for treatment of migraines. Your provider will determine which medications and dose will be appropriate for you. The medicines are chosen based on your type of headache, other medical conditions, allergies, and previous response to certain medicines. Listed below are the most common classifications of medications we use. Within each classification, there may be several different medications.
Antihistamines
Antihistamines are primarily used to treat allergies, and they are also helpful in promoting relaxation during your treatment and may cause drowsiness. Some antihistamines are known to abort headaches.
Anti-emetics
Anti-emetics are used to prevent and/or to treat nausea and vomiting, and some are known to abort headaches. You may not have nausea upon arrival for your treatment, but some medicines have the potential to cause nausea. A few of the anti-emetic medicines may cause drowsiness.
Anti-seizure
Anti-seizure medicines have shown to be effective in the prevention as well as the treatment of headaches. It does not mean that you have a seizure disorder. These medicines help to desensitize painful, irritated nerve endings than can become inflamed during migraine episodes.
Muscle Relaxant
These medicines help to relax your muscles, especially in the neck and shoulder areas. Tightening of the muscles may contribute to your headache pain. The most common one used for headache treatment is magnesium sulfate. It is normal to feel flushing or warmth of your skin while infusing magnesium.
Steroids
Steroids are used for their strong anti-inflammatory capability. They help to decrease the swollen blood vessels, which will help to relieve headache pain. Steroids may also help to prevent headache from recurring. Steroids are often used to treat exacerbations of Multiple Sclerosis. These are not the types of steroids abused by some athletes. You could experience some difficulty sleeping the night after receiving this medicine.
NSAIDs (non-steroidal anti-inflammatory drugs)
Non-steroidal anti-inflammatory drugs also help to decrease swollen blood vessels that may cause increased headache pain. This class of medicine is milder than steroids and has fewer side effects. DHE-45 (dihydroergotamine) DHE works as a vasoconstrictor, reducing the swollen vessels, thus relieving pain . When receiving DHE for the first time, the dose may be divided into smaller amounts to increase your tolerance and decrease the chance of nausea. After receiving DHE, your blood pressure will be monitored for signs of elevation.
Other Migraine Resources
American Headache Society
Americanheadachesociety.org
The AHS provides information for clinicians as well as for patients and families of patients with headaches.
American Council of Headache Education (ACHE)
www.achenet.org
The patient education portion of the American Headache Society
American Headache and Migraine Association (AHMA)
Patient group, part of AHS that provides education, support and advocacy
National Headache Foundation
Provides information and news, and a listing of support groups
National Migraine Association (Migraine Awareness Group - MAGNUM)
Migraines.org
A not-for-profit public information and advocacy organization. The site provides information, publications and news.
Books:
The Migraine Brain by Christine Bernstein, M.D. Free Press, 2008
Heal Your Headache: the 1-2-3 Program by David Buchholz, M.D. Workman Publishing, 2002
Knock Out Headaches by Gary Ruoff, M.D. Spry Publishing, LLC
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