Migraine

Migraine headache affects thousands of people every day. Although the specific cause of migraines is elusive. Multiple factors like vascular spasms and neurohormonal imbalances are theorized as a cause.

Migraine headache is characterized by pulsating moderate to severe head pain lasting from 4 hours to several days. The location usually occurs on one side of the head, but may develop on both sides, on top, in the back, or in the front of the head. Strange smells or odd sights (aura) can preceed the headache as well as other warning signs like excessive yawning, craving sweets, mood changes, and fatigue. During the headache, people may experience additional symptoms of nausea, vomiting, and adversion to light or sound.
For relief, most people find a secluded dark place to lie down and sleep. Some use ice packs and deep breathing.

For fast headache relief people often use medicine such as NSAIDS, acetaminophen, aspirin, caffeine, Fiorinal or Fioricet, triptans, or opioids.

Prevention includes eliminating triggers, taking correct dose, duration, and frequency of fast acting medicine, use of prophylactic medicine, balancing hormone levels, and treating any underlying conditions. For essential oil use in headache, click here. (pdf) or go to our essential oil page.

Triggers include change in barometric pressure, lack of sleep, anxiety, changes in hormones (especially drops in estrogen prior to menstruation), specific foods, certain medicine, physical exertion including sex.

Food triggers: caffeine, chocolate, alcohol, MSG, nuts, aged cheese, fresh baked goods, red wine, nitrates in processed food.

Medication triggers: oral contraceptives, weight loss medicine, SSRI’s (anti-depressant), nitroglycerin.

Immediate relief (adult dosing):
1. Ibuprofen
800mg every 6-8 hours with food. People with history of stomach ulcers or renal disease consult with your physician before taking ibuprofen.

2. Acetaminophen
1000mg every 4-6 hours. Do not exceed 4 grams per day.

3. Triptans are a class of medications which bind to serotonin receptors in the brain’s arteries resulting in vasoconstriction and reduced inflammation thus relieving headache. Triptans are taken at the onset of a migraine headache with a repeat dosage two hours later. Triptans should be limited to two times a month otherwise rebound headaches may occur. Use only for immediate migraine relief. Do not use for migraine prevention.

Triptans include sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), zolmitriptan (Zomig), almotriptan (Axert), frovatriptan (Frova).
Dosages vary on the specific agent. Imitrex comes in tablet, nasal spray, and injectable formulations.

Potential side effects include parasthesia (change in sensation), musculoskeletal pain or tightness, warm/cold sensations, fatigue, headache, drowsiness, nausea, vomiting, and high blood pressure.
Therefore, discussed potential side effects with your physician before starting this medicine.

Contraindications include patients with cardiovascular disease (e.g. history of heart attack, stroke, or coronary artery disease), uncontrolled hypertension, or severe liver disease
Triptans should not be taken in combination with MAO inhibitors, ergot derivatives (eg ergotamine, Pergolide), sibutramine. Caution must also be used in combination with propranolol, and agents which modulate serotonin (including tramadol, some antidepressants, dextromethorphan, Gingko Biloba and St. John’s Wort). Enhanced serotonin activity can lead to serotonin syndrome (confusion, agitation, coma, fast heart rate and respiratory rate, high blood pressure, muscle jerking or increase tone, fever, sweating, nausea, tremor, and difficulty walking)

4. Opioids (Codeine, Hydrocodone, Oxycodone)
Emergency use only. Consult physician.

5. Antiemetics (anti nausea): Often used in combination with above analgesics
prochlorperazine (Compazine): 5-10 mg 3-4x a day orally or intramusculary (IM); 25mg twice a day rectally.
promethazine (Phenergan): 12.5 – 25mg every 4-6 hours orally, IM, rectally.
trimethobenzamide (Tigan): 300mg 3-4 x a day orally or 200mg 3-4 x a day IM

Essential Oils for Headache   02/10/09

Single Oils: Wintergreen, Peppermint, PanAway
Oil blend:
 4 drops Wintergreen
 2 drops lavender
 3 drops German chamomile
 1 drop clove
 2 drops cobaiba

Application
1. Inhalation
Diffuse 15 minutes 3-5 times a day
Direct  3-8 times a day
2. Topical
Dilute with carrier oil and massage into back of neck, temples (avoid eyes), forehead and under nose 3-5 times a day
3. Oral
Place a drop on the tongue and push tongue to the roof of the mouth.

Peppermint tea for nausea
In 4-6oz of tea water (not boiling), place one teaspoon of Agave or honey with one drop of peppermint.

M-grain is specifically formulated for migraine headache.
Contains
Marjoram
Lavender
Peppermint
Basil
Roman Chamomile
Helichrysum

Diffuse 3-5 times a day
Inhale directly 3-5 times a day.
Place a few drops in warm bath water.
Dilute one part M-grain with one part vegetable oil. Apply directly on forehead, crown of head, back of neck, shoulders, temples, or feet.

Reference: Essential Oils Desk Reference by Essential Science Publishing.