How to manage my recurring one-sided migraines and nausea?

Question

Hello doctor,

I experience severe headaches about twice a month that are completely debilitating, usually affecting one side of my head with intense throbbing pain. These headaches cause nausea and vomiting, and I become extremely sensitive to light and sound during the episodes. I have to lie in a dark, quiet room for several hours or sometimes an entire day until the pain subsides.

I have noticed that certain triggers, such as stress, lack of sleep, or hormonal changes around my menstrual cycle, tend to bring them on. Could these be migraines, and what preventive treatments or medications can help reduce their frequency and severity?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The symptoms you describe, one-sided throbbing pain, nausea or vomiting, light and sound sensitivity, triggered by stress, sleep changes, or menstrual cycle, are very typical of migraine attacks. Migraines occur due to abnormal brain excitability and changes in blood vessels and pain pathways, often influenced by hormones and lifestyle triggers.

I would suggest the following measures:

Acute relief (to stop an attack once it starts).
Triptans (such as Sumatriptan and Rizatriptan) are migraine-specific and more effective than regular painkillers.
NSAIDs (nonsteroidal anti-inflammatory drugs) like Naproxen can help if taken early.
Resting in a dark, quiet room supports recovery.

Preventive treatment to reduce frequency or severity includes:

Daily preventive medicines: beta-blockers (such as Propranolol), antiepileptic drugs (such as Topiramate and Valproate), or antidepressants (such as Amitriptyline).
Hormonal management of attacks is strongly linked to periods.
Newer treatments: CGRP (calcitonin gene-related peptide) monoclonal antibody injections, such as Erenumab, Fremanezumab, or Galcanezumab, taken monthly, can be very effective in resistant cases.
Botulinum toxin (Botox) injections are used in chronic migraine (15 headache days per month).

Lifestyle strategies include maintaining regular sleep and meal timings, staying well hydrated, and identifying and avoiding personal triggers such as stress, certain foods, alcohol, and hormonal changes. Regular aerobic exercise and stress-reduction practices like yoga and meditation can also help.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.