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There are numerous ways of classifying headaches including (1) vascular headaches; (2) tension-type (muscle contraction) headaches; and (3) traction and inflammatory headaches. In the first group, the vascular headaches includes migraines and cluster headaches.
Migraines
Migraine headaches affect an estimated 16-18 million Americans. Migraines are periodic headaches, usually unilateral (one-sided) in onset, but they may become generalized. They are associated with irritability and nausea and often with photophobia, vomiting, constipation and diarrhea. Pain is usually limited to the head but may include the face and the neck. Migraine is more common in women than in men, usually occurring in the 2nd and 3rd decades of life. Factors involved may include stress, fatigue, certain psychological patterns, diet (alcohol, tyramine, aspartame, cured meats), hypoglycemia, and hormonal changes.
Cluster Headaches
Cluster headaches occur primarily in males at a ration of about five males to one female. In contrast to migraine headaches, cluster headaches only rarely involve a hereditary history. The clinical picture involves pain lasting from a few minutes to several hours, most often 30-45 minutes. It is severe and burning and always unilateral (one-sided), although an attack can vary from side to side, it almost never occurs on both sides at the same time. The pain may be so severe that the patient feels better walking around as opposed to patients with a migraine who often prefer to lie down. A chronic cluster headache is defined by attacks occurring for more than a year without remissions or with remissions lasting less than 14 days.
Treatments
There are many traditional drugs used for treating migraine and cluster headaches. However, many of those medications have limitations which offset their usefulness. These limitations include multiple side effects, high costs and require a significant amount of time before providing pain relief. A therapy may be either prophylactic or abortive. If headaches are experienced only once every month or 2, abortive therapy is preferable. Lidocaine HCL is a local anesthetic which is used in abortive therapy, is safe, brings rapid results, and is available (is not a controlled substance.)
Our compounding pharmacists can custom make this and several other alternatives to those medications which target migraine pain quickly and provide rapid relief, with few side effects, and less cost. Studies have shown that Lidocaine Hydrochloride nasal solution is a safe and effective agent in aborting migraine and cluster headaches in as little as 15 seconds!
Additional treatments include:
- Suppositories:
We are capable of compounding a product similar to the discontinued Cafergot-PB suppositories to prevent migraine headaches. Ergtomine Tartrate suppositories formula is used to abort or prevent vascular headaches such as migraine or cluster headaches that may be complicated by tension and GI disturbances, e.g., nausea.
- Troches:
Dihydroergotamine troches can be prepared to deliver medication to treat migraine or cluster headaches.
Piroxicam sublingual troches can also be prepared for symptomatic treatment of migraine headaches. Piroxicam, which is a non-steroidal anti-inflammatory, has been found to significantly reduce pain severity after just 15 minutes. 75% of patients reported complete relief within 60 minutes.
- Capsules:
As shows by the results of an open study, compounded capsules of high-dose riboflavin (Vitamin B2) can be used to treat and prevent recurrences of acute migraine headaches. To treat an active migraine, the study shows, 200mg capsules are taken at the first sign of a migraine headache and to be repeated in 1 to 2 hours if symptoms persist. For prophylactic (preventive) therapy, 400mg doses taken daily for 3 months can reduce migraine severity by as much as 70%.
There are other variations that can be used and we would be glad to discuss them with your physician. Contact us today to learn more.
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