Hello XXXXXXX

Thanks for your query,

Before I respond to your question, I would like to tell you that headache can due to viral infection of brain/tumor, problem in the blood vessel of brain, migraine, tension headache, cluster headache and so on. Secondary causes need exclusion before the diagnosis of migraine is secured.

If she has migraine (diagnosed by a neurologist) the following approach will help her

1. Acute attack: acute attack can be largely prevented rather than treated. One must learn to find out the trigger of the attack like lack of sleep, poor food habit, excessive coffee, perfumes etc. During an attack of migraine she can use simple analgesics like paracetamol, ibuprofen or nasal sumatriptan spray. Out of all the options for treatment of migraine, nasal spray will have fewer side effects. Among the analgesics, paracetamol will have the least side effects.
2. Medicines that can alter the migraine should be started as these drugs will decrease the frequency of attack and ultimately she will not require analgesics. The medicines in this category are topiramate (if she is overweight she can use it. This will cause weight loss), valproate (should not be an option in females), propranolol and amitriptiline. You may opt any of these except valproate.

Please note that medicines used to treat migraine may have some side effects which can be known only after use of the medicine and can be stopped in case of problem and we can switch over to other medicines. Please visit a local neurologist who will guide you through a good discussion and you will be able to selects an appropriate medicine for her


I hope that I have answered your query

In case you have further query, please get back to me

Best wishes


Dr Gopal K Dash
Neurologist XXXXXXX Hrudayalaya Hospital, Bangalore
email: YYYY@YYYY

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