There are two main treatment types used for migraines: abortive and prophylactic. Abortive treatments are used when you have a migraine to try to reduce the severity or duration of your migraine. Prophylactic treatment is migraine prevention, and, all things considered, is the preferred treatment method. If you can avoid getting migraines, it’s better than trying to stop them once you’ve developed them.
There are many prophylactic treatments available, but, unfortunately, they have significant side effects.
Serious Side Effects for the Most Popular Medication
The most popular migraine prevention drug is topiramate. This antiepileptic drug has been approved for the prevention of episodic migraines (15 attacks or fewer a month). In clinical trials, about 50% of migraine sufferers saw a 50% or more reduction in migraine frequency, compared to less than 25% of those taking placebo. Unfortunately, this migraine reduction comes with a serious cost.
There are some minor and transient side effects of topiramate, and overall about ⅔ of people taking topiramate experience some side effects. Tingling in the hands and fingers is probably the most common side effect. This isn’t related to neurological damage, and tends to pass. People also experience nausea. Although this passes, appetite is reduced, leading to weight loss. It also affects taste, most commonly causing carbonated beverages to taste flat. Anorexia is sometimes listed as a side effect, occurring in up to 18% of people taking topiramate in some trials, but not showing up in others. Some people may experience diarrhea, which may contribute to weight loss.
The most serious common side effects with topiramate are cognitive and behavioral disturbance. People may experience memory problems and may find it difficult to select the right word when speaking or writing. Cognitive dysfunction may occur in more than 20% of people who try topiramate. Sometimes cognitive dysfunction passes, and gradually increasing the dose (the low and slow approach) tends to reduce side effects.
A rare, but dangerous side effect, is acute glaucoma. In this condition, the pressure regulation system in the eye gets closed, causing a dramatic increase in pressure in the eye that can cause lasting damage to the optic nerve. People who experience vision problems on topiramate should stop using it and contact their doctor.
Topiramate is not recommended for women who are pregnant or who may become pregnant during treatment.
Antidepressants for Migraine Prevention
Other migraine prevention medications are antidepressants. The most popular of these is amitriptyline. Amitriptyline is about as effective as topiramate for migraine prevention. It also had a similar occurrence of side effects, though it had fewer serious side effects. Dry mouth, fatigue, sleepiness, and weight gain are the most common side effects for amitriptyline treatment of migraines.
Muscle spasms, fainting, tremors, seizures and hallucinations are among the uncommon but serious side effects of amitriptyline.
BOTOX ® Injections for Migraines
BOTOX ® injections for migraines are increasing in popularity. We have already written about some of the side effects of BOTOX ® injections for TMJ and related migraines. New research on these side effects deserves specific attention, and we’ll talk about them soon.
Consider Medication-Free Treatment Options
With the potential for serious side effects associated with these migraine prevention drugs, it makes sense that people should consider drug-free treatment options, which have comparable rates of effectiveness with some of these drugs. People who try drug treatments rarely stay on them for long, because they often don’t work, and in the meantime you are exposed to serious side effects and then serious side effects of withdrawal.
Before trying drugs for your migraine, consider where nonsurgical, drug-free TMJ treatment could give you relief. To talk about migraine relief in Columbia, SC please call (803) 781-9090 for an appointment with a TMJ dentist at Smile Columbia Dentistry.