How are migraines managed in young adults?

Question

Hello doctor,

I am 26 years old and have been getting terrible headaches on one side of my head, sometimes with nausea, light sensitivity, and even blurry vision. They last for hours and make it impossible to work or concentrate. Someone said it sounds like migraines.

What exactly causes them?
How are they different from regular headaches?
Are there medications that can prevent them, not just treat the pain?

I am worried that it is starting to affect my daily life.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

It sounds like you are describing migraine headaches (neurological disorder showing recurring headaches), especially with symptoms like pain on one side of the head, nausea, light sensitivity (photophobia), blurred vision lasting for hours, and impacting work and concentration.

They involve abnormal brain activity that affects nerve signals, chemicals, and blood vessels in the brain. The exact cause is not fully understood, but several triggers and contributing factors are known.

The exact cause is multifactorial. Migraines tend to run in families. The triggers, which can vary from person to person, are hormonal changes (for example, menstrual cycle), stress or anxiety, sleep disturbances, certain foods (for example, aged cheese, chocolate, caffeine), weather changes, strong smells, lights, or loud noises.

I would suggest the following treatment options:

Acute or abortive medications can be taken when a migraine starts. Examples are:

1. NSAIDs (non-steroidal anti-inflammatory medications like Ibuprofen and Naproxen).

2. Triptans (for example, Sumatriptan, Rizatriptan).

3. Ergots (less commonly used now).

4. Anti-nausea drugs (example, Metoclopramide).

Preventive or prophylactic medications are taken daily to reduce the frequency or severity.

1. Beta-blockers (for example, Propranolol).

2. Antidepressants (for example, Amitriptyline).

3. Anti-seizure medications (for example, Topiramate and Valproate).

4. CGRP (calcitonin gene-related peptide) inhibitors (for example, Erenumab and Fremanezumab).

5. Botox injections for chronic migraines are used.

These are typically prescribed if you have frequent migraines, more than or equal to four times a month. The migraines are severely disabling when acute medications do not work well or are used too often. There is a risk of rebound headaches.

Some of the lifestyle changes that can help are

Track your triggers with a headache diary.
Have a regular sleep schedule.
Stay hydrated.
Limit caffeine. Manage stress with meditation and exercise.
Avoid skipping meals.

Given that this affects your daily life, you should go to a hospital to confirm the diagnosis. Sometimes brain imaging is done to rule out other causes.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.