Migraine

This service is for patients who require treatment for acute migraine episodes. Unfortunately, we are unable to offer preventive / prophylactic treatments for migraine. This can be arranged by video consultation with one of our doctors. Click here.

What is a Migraine?

Migraine is the third most common disease in the world (behind tooth decay and tension-type headache) with an estimated global prevalence of 14.7% (around 1 in 7 people). It affects around 1 in every 5 women and around 1 in every 15 men. Migraines usually begin in early adulthood or adolescence, and peak during your thirties.

Migraine generally features a moderate to severe one-sided throbbing headache which is episodic (lasting hours or even days), with total freedom between attacks. The frequency of migraines varies from person to person. It is possible for years to pass between migraine attacks. Migraines can be disabling and affect your ability to perform daily activities. 

There are three main types of migraine, including:

1. Migraine with aura – where there are specific warning signs just before the migraine begins; these can include visual disturbances such as seeing flashing lights or blind spots; or other disturbances such as difficulty speaking or tingling in the arms, legs or face.

2. Migraine without aura – this is the most common type, where the migraine happens without the specific warning signs.

3. Migraine aura without headache, also known as “silent migraine” – where an aura or other migraine symptoms are experienced, but a headache does not develop.

There are a number of possible migraine triggers, including:

1. Stress - stress at work or at home triggers 80% of migraines. 
2. Hormonal changes in women - fluctuations in oestrogen such as before or during menstrual periods, pregnancy, and menopause. Hormonal medications such as combined hormonal contraceptives (pill, patch or ring) or hormone replacement therapy can also worsen migraines in some women.
3. Physical factors - intense physical exertion, including sexual activity.
4. Sensory stimuli - sensory stimuli may include bright lights and sun glare; as well as loud noises and strong smells.
5. Drinks - including alcohol (especially wine) and caffeine.
6. Sleep changes - missing sleep, getting too much sleep, or jet lag.
7. Medications - as mentioned above, the combined oral contraceptive pill can worsen migraines; as well as vasodilators such as nitroglycerin.
8. Foods and food additives - salty processed foods, monosodium glutamate (MSG) and the sweetener aspartame can all trigger migraines; as can skipping meals or fasting.

The underlying causes of migraine are not yet fully understood, although genetics, environmental factors, and imbalances in brain chemicals such as serotonin are all thought to play a part. 

Migraine is not classed as an inherited condition. However, it often occurs in several members of the same family. Therefore, you are more likely to develop migraine if you have one or more close relatives who have migraine.

Around two-thirds of patients with chronic migraine have medication overuse. Medication overuse is defined as taking paracetamol or non-steroidal anti-inflammatories on more than 15 days per month, or taking triptans/ combination analgesics (e.g. solpadeine) on more than 10 days per month.

There are some things you can do to try to prevent migraines without medication:

• If you suspect a specific trigger is causing your migraines, avoiding this trigger may help to reduce your risk of experiencing migraines.
• It may also help to maintain a healthy lifestyle, ensuring regular exercise, meals and sleep; as well as maintaining good hydration, and limiting your caffeine and alcohol intake.
• There is some evidence to suggest that acupuncture may also be effective in preventing migraines (10 sessions over 5-8 weeks). 

Migraines cause attacks of headaches, often making you feel sick or causing you to be sick. Medical treatment options include, painkillers, anti-inflammatory medicines, anti-sickness medicines, and triptan* medicines. A medicine to prevent migraine attacks is an option if the attacks are frequent (8 headache days per month).

*Triptans are a prescription medication for migraines. They work by narrowing enlarged blood vessels in the brain that are thought to cause migraines, thereby reducing the severity and duration of migraine attacks. Triptans should be taken as soon as you feel a migraine coming on. The sooner you take them, the more effective they can be. However, triptans are not suitable for everyone.

Who Is This Service For?

This service is suitable for you only if:

• You have been diagnosed with migraines in the past by a doctor or specialist. 
• You are over 17 years of age.
• You are not looking for medication to be used for another adult or for a child in your care. We define a child as anyone under the age of 17 years. 
• You are not pregnant, planning to become pregnant or breastfeeding. 

This service is not suitable for you if:

• You have never been diagnosed with migraines in the past by a doctor
• You are under the age of 17 years old or you are looking to use this service for medication for another adult that is not you. 
• You are pregnant, planning to become pregnant or breastfeeding. 
• You had your first migraine in the last 12 months. 
• The symptoms of your migraine began after turning 50 years of age.
• You have been diagnosed with certain diseases that affect your blood vessels. 
• You have been diagnosed with liver or kidney disease.
• You are looking for a prescription for a prescription for preventative treatment, (e.g. topiramate, gabapentin, ergotamine) or opiates.
• You are allergic to any ingredients in the medications listed above.

How the service works

• Online consultations with Irish based doctors
• Our doctors issue a prescription if medically safe and suitable
• Valid in any Irish pharmacy to buy your medication
• Prescription sent to your chosen pharmacy via secure email (Healthmail) within minutes of approval

The accuracy of the information you provide is very important for the safe prescribing of the most suitable type of medication. 

The information that you provide is treated with the same patient-doctor confidentiality as in a normal face-to-face consultation.