The pharmacologic management is done by using agents that abolish the acute migraine, including normal analgesics and specific drugs like ergotamine and prophylactic drugs that are taken regularly such as: methylsergide (Pryse-Phillips et al. 1998). Risk of using the pharmacological products can include: Low B. P., Decreased Libido, Nausea,depression, Sedation, Dry mouth, Sleepiness, Increased Appetite, Weight gain,and Kidney and other organ damage. Due to these possible side effects, a relevant proportion of patients prefer non pharmacological or complementary therapies for migraine headache prevention and treatment. A brief account of different medication and non-medication approaches for the prevention /treatment of migraine headache are given as under:

Out of these approaches some are described as:

5.1) Migraine & Allopathic System: In 1976, Propranolol was reported to be efficacious and in 1993 Sumatriptan (first Triptan) was reported for migraine treatment. Then Valproic acid and Topiramate was approved for migraine prevention. 

Intranasal Sumatriptan & nasal Zolmitriptan but not oral formulations had been reported for children and adolescents due to their quicker onset and shorter duration of migraines in children.

Although Triptans should be avoided in patients with vascular disease, uncontrolled hypertension or hemiplegic migraine. (Gilmore and Michael, 2011)

Most of the drugs effective in the treatment of migraine are members of one of the three major pharmacological classes namely:Anti-inflammatory agents, 5-HT₁ agonists and dopamine antagonists. 

5.2) Craniosacral Therapy

This system of therapy extends from the head down to the sacrum and coccyx because the brain, spinal cord and all related structures are the contents of the craniosacral system. Restriction or imbalances in it may directly affect any or all aspects of central nervous system performance. In a study with twenty participants of 20 years – 50 years age group, suffered from at least two migraine attack per month were provided with this therapy and the results indicated that it could be considered as a potential therapy for migraine sufferes with the aim of improving quality of life. (Arnadottir and Sigurdardotirr, 2013)

5.3) Migraine & Ayurvedic System: Various method are applied for the treatment of migraine as given under:

Shirolepa – Application of herbal pastes which pacify Pitta Dosha like Sandalwood, camphor, Jatamansi.

Shiro Dhara – pouring of thin stream of liquid over scalp.

Taila dhara - with oils like ksheerabala taila, chandanadi taila is carried out where Vata involvement is high.

Ksheera dhara (cow milk) - is done when Pitta involvement is more.

Takra Dhara (buttermilk) - is done when there is obstruction to Vata passage is to be removed.

Kavala graha – Oil pulling, with chandanadi taila, mahanarayana taila.

Shirovasti – Retaining the medicated oils over the leather cap fitted over the scalp. Any vata-pitta pacifying oils are beneficial for this purpose.

Sneha nasya – Instillation of medicated oil scan be carried to the nostrils. Shadbindu taila or Anu taila yield significant benefits in this condition.

Ayurvedic Medicines Useful In Migraine

Herbs Useful In Migraine

Simple Home Remedies Useful In Migraine Headache

1. Tender leaves of jasmine or tender leaves of pomegranate are taken along with a pinch of salt and crushed well to obtain fresh juice. Early in the morning,preferably in empty stomach, 2-3 drops of this fresh juice is instilled to both the nostrils. Procedure is repeated once again evening hours (6-7 pm). This reduces the severity of headache in migraine.

2. One fist full of Doorva grass (cynodan dactylon) is taken and its fresh juice is obtained. To this, 2 pinch of licorice powder is added and mixed well. This is consumed during the noon hours. Procedure is repeated for 20-30 days. This helps to reduce the severity of illness significantly.

3. Take coriander seed powder – 1 teaspoon. add it to one cup of water, leave it as it is at night, next day morning, drink it on empty stomach.

4. Soak 5 raisins and 5 almonds in water at night, next day morning, eat them.

5. Saffron home remedy for migraine.

6. Take fresh leaves juice of muranga / munanga plant. Put 2-2 drop of leaf juice on both nostrils twice a day for 3 days. It makes relief form migraine headache.

7. The best homemade remedy is that the patient is given jalebi cocked with desi ghee.

8.Another treatment is by giving soft and tender leaves of Calotropis gigantiana/ Calotropis procera (Madar / Akh / Akhra) in Gur / Jaggery to the patient just before sunrise because the migraine patient usually have headache problem after sunrise and increases with the advancement of the sun.

5.4) Migraine & Homoeopathic System:

According to this system migraine is said to be soothed and cured by a wet rubbimg of the whole body (78^o) in the morning and about four three quarter steam baths a week, followed by a lukewarm bath (88^o) and washing &douching of the head. Relief from the pains may be obtained by massage and stroking the forehead vigorously with the patient’s eyes closed. Some Homoeopathic remedies include: Natrum Muriaticum, Sangunaria, Sepia, Silicea,Spigelia, Belladonna.The therapy provided with Natrum Mur 200 with repeate ddose after 7 days was reported with no complaints after one month and for headache with mild intensity was repeated with 1 dose Natrum Mur 200 which gave full comfort after 15 days. (Dr. JiyaHilal and Dr. Mazoor, 2013)

5.5) Migraine & Unani System:

A Unani physician defines pain as perception of unease in the body caused by impaired temperament or loss in continuity (Baig et al. 2014). Suda is pain produced in organs of the head caused either by imbalance of temperament due to change in matter. Application of pressure by tight bandage lowers the intensity of pain. Diet therapy and regimental therapy are used for treatment. During the time of episodes, the patient is taken to a dark and silent room being pleasant with all activities down. In case of constipation laxative is provided for the prevention of vomiting ice cubes are given to sip, tight bandage applied on head to reduces pain as well as massage on head is done for sedation, analgesicis provided (Mujeeb et al. 2015). Nearly all the classical texts of Unani medicine claims for successfully treating this disease without any unwanted effects. (Arshad et al. 2013)

5.6) Non-medication Therapy of Migraine:

In addition to diet, alternative or complements to drug treatments includes:bio feedback, visualization & hypnotherapy, muscle relaxation, stretching exercise, aerobic/oxygen/hyperbaric oxygen therapy, trigger point compression,cold packs or a heating pad, electrical stimulation, massage, acupuncture and psychotherapy etc. Magnesium and riboflavin vitamin supplements have also been found beneficial.

Acupuncture is found to reduce frequency of migraine headache, both in combination or independent of medication. Mechanism by which acupuncture provides an analgesic effect in migraine treatment is not fully understood, several theories have been hypothesized. (Sun Edelstein and Mauskop, 2011)

The rationale for oxygen therapy in headache treatment is based in the ability of oxygen to constrict distal cerebral resistance vessels while preserving tissue oxygenation, even at pressure above 1 atmosphere. (Sun Edelstein and Mauskop, 2011)

Hypnosisis an alternative therapy for those patients who do not want pharmacological therapy or for those who need more therapy to control pain due to migraine attacks. (Ardore et al. 2015)

Patients with migraine may be abnormally sensitive to one or more of these dietary items like citrus fruits, fatty or fried foods,chocolates, nuts, ice-cream, yogurt, sour cream, meat, vegetable extracts,tomatoes, caffeine containing drinks, caffeine withdrawal, alcoholic drinks etc. Hence, fasting or skipping meals is also a common reason for headache recurrence in migraine sufferers. (Arora and Kaur, 2008)