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Normally, migraines occur when triggered by various stimuli such as light, color, sound, and in some cases, women may feel headache symptoms before their menstrual cycle. This happens because estrogen, our female sex hormone, affects the function of neurotransmitters in the brain such as serotonin, which is related to the occurrence of migraines. Therefore, hormonal changes are another cause that can trigger migraine headaches. This disease is definitely close to all of us. Phyathai 3 Hospital would like to invite everyone to get to know more about migraines with Dr. Rudeerat Wattanawong, a neurologist at Phyathai 3 Hospital.
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<h2>What is a migraine headache?</h2>
Migraine headaches are classified as primary headaches, a common neurological disorder. In females, migraines are found about 2-3 times more than in males (approximately 18.9% in females and 9.8% in males). According to the Global Burden of Disease Study 2016, migraines are the second most severe neurological disorder causing disability, second only to stroke.
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<h2>How severe must the headache be to qualify as a migraine?</h2>
<ul>
<li style="font-weight: 400">Headache lasting continuously from 4 to 72 hours</li>
<li style="font-weight: 400">Usually presents as one-sided headache or throbbing pain pulsating with the heartbeat, ranging from moderate to severe intensity, with findings that
<ul>
<li style="font-weight: 400">About 90% of migraine patients experience moderate to severe headache pain</li>
<li style="font-weight: 400">Approximately 75% of patients have reduced work efficiency during an attack</li>
<li style="font-weight: 400">More than 50% of patients cannot continue daily activities or need to rest during an attack</li>
</ul>
</li>
<li style="font-weight: 400">Nausea or vomiting may accompany the headache</li>
<li style="font-weight: 400">Exposure to triggers such as bright light or loud noise can worsen the pain</li>
</ul>
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<h2>Migraine types are divided into 2 groups</h2>
Besides the symptoms mentioned, migraine headache patients can currently be classified into 2 groups:
<ul>
<li style="font-weight: 400">Episodic migraine refers to those who have headache frequency less than 15 days per month</li>
<li style="font-weight: 400">Chronic migraine refers to those who have headache frequency equal to or more than 15 days per month, with this pattern continuing for more than 3 months. Patients in this group are advised to see a doctor promptly for targeted treatment as it may lead to psychiatric conditions such as depression and anxiety.</li>
</ul>
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<h2>What is the best treatment for migraine headaches?</h2>
Currently, there are various treatment techniques for migraines. This article will focus on medication treatment, which includes oral tablets and intravenous administration.
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<h2>For oral tablets, there are 3 main groups:</h2>
<ul>
<li style="font-weight: 400">General pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen, naproxen, and diclofenac</li>
<li style="font-weight: 400">Migraine-specific pain relievers such as ergotamine and triptan drugs, of which Thailand has 2 types: sumatriptan and eletriptan</li>
<li style="font-weight: 400">Pain relievers that alleviate and prevent migraines, such as RIMEGEPANT (Nurtec), a sublingual tablet that dissolves quickly in the mouth without water. It is the first tablet used to treat and prevent migraine headaches, suitable for those who dislike swallowing pills but do not want injections. Even when taken during nausea or vomiting, the medication will not be vomited out. The drug acts to relieve pain within 1 hour and lasts up to 48 hours.</li>
</ul>
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<h2>For intravenous medication</h2>
To improve the quality of life for migraine sufferers, Phyathai 3 Hospital has introduced Vyepti® (Eptinezumab) as another treatment option. It is administered as an intravenous drip similar to saline over 30 minutes, without the need for recovery or hospitalization.
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<h2>Advantages of migraine treatment with intravenous medication</h2>
<ol>
<li style="font-weight: 400">VYEPTI is specifically designed to prevent migraines, providing good efficacy and fewer side effects compared to older preventive migraine drugs</li>
<li style="font-weight: 400">Intravenous administration relieves pain faster, within 24 hours, because the drug is 100% absorbed into the bloodstream</li>
<li style="font-weight: 400">It can prevent migraines for up to 3 months per dose, reducing hospital visits and minimizing disruption to daily activities</li>
<li style="font-weight: 400">Helps alleviate other symptoms such as nausea, photophobia, and phonophobia</li>
<li style="font-weight: 400">The drug is highly safe, has few side effects, can be used with other medications, and is suitable for patients with multiple underlying diseases</li>
</ol>
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<h2>Who can receive migraine treatment via intravenous medication?</h2>
<ul>
<li style="font-weight: 400">Individuals aged 18 years and older</li>
<li style="font-weight: 400">Those who regularly experience severe migraine headaches</li>
<li style="font-weight: 400">Those who have tried other medications without improvement and need adjustment</li>
<li style="font-weight: 400">Those who want effective medication with low side effects</li>
<li style="font-weight: 400">Those who frequently need emergency pain relief medication and want to reduce painkiller use</li>
<li style="font-weight: 400">Those who are inconvenient to visit doctors frequently, have busy schedules, or travel long distances</li>
<li style="font-weight: 400">Those with multiple underlying diseases or medications (no drug interactions)</li>
<li style="font-weight: 400">Those who dislike taking pills or have difficulty swallowing medication</li>
</ul>
Migraine can be cured. Don’t let the (head) pain take away the happiness from your life.
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For more information, please consult 
Brain and Nervous System Center, Phyathai 3 Hospital

Normally, migraines occur when triggered by various stimuli such as light, color, sound, and in some cases, women may feel headache symptoms before their menstrual cycle begins.

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