Thirteen percent of Americans—about 38 million people—suffer from 偏头痛, and every one of them has a different experience with the condition. Treatment has to be as individualized as they are.
然而, with new treatments on the market during the past few years and 研究 continuing at a record pace, patients and their providers may be able to find an optimal treatment plan.
预防治疗
- CGRP单克隆抗体
Since 2018, there have been a number of breakthroughs in 偏头痛 treatment. 的 first drugs approved by the Food and Drug Administration (FDA) were a new class called monoclonal antibodies that target calcitonin gene-related peptide (CGRP). 的se drugs prevent 偏头痛s before they happen by stopping the release of proteins that prevent inflammation.
CGRP monoclonal antibodies are the first 偏头痛 prevention drugs designed specifically for that purpose. 在此之前, drugs used for 偏头痛 prevention had been designed for other uses but were found to be effective for stopping 偏头痛s. β受体阻断剂, 抗癫痫药物, 抗抑郁药, and even onabotulinum toxin have all helped people with 偏头痛 to varying degrees.
然而, the monoclonal antibodies don't work for everyone. "的se really were the first designer drugs for 偏头痛 prevention,” says Kathleen Digre，医学博士他是美国联邦调查局前局长 Division of Headache and Neuro-Ophthalmology 犹他健康大学的研究员. “For some people, one of these treatments may be really helpful. 然而, it's not going to be always magic".
Some of these medications also have side effects that may make them less than attractive to patients. Those can range from constipation to a loss of libido, 思维的变化, 或者血压问题, 根据迪格雷的说法. Providers need to work closely with patients to make sure the risks don't outweigh the benefits.
- 有
有 are taken orally and are small CGRP molecule blockers. Instead of lasting a full month for prevention, they must be taken every day or every other day to prevent a 偏头痛. But not all gepants have been approved as a preventive treatment.
急性治疗
CGRP monoclonal antibodies and Gepant preventives are the “new kids on the block” when it comes to 偏头痛 treatment. 还有许多急症治疗方法. 的 biggest breakthrough in this category came in the 1990s with the introduction of triptans. 的se drugs work to relieve 偏头痛 symptoms by binding serotonin receptors in the brain and blood vessels.
像药物, gepants bind to the blood vessel; unlike triptans, gepants don’t constrict the blood vessel. This may make gepants a better solution for patients with cardiovascular disease, 根据一篇由 美国国立卫生研究院. 曲坦类药物, lasmitidan affects the 5HT1F receptor and does not cause vaso-constriction although it can cause drowsiness.
New acute and preventive treatments may be on the way. Migraine specialists like Digre expect other therapies to be coming.
偏头痛的设备
Aside from medications, new devices also offer help to individuals with 偏头痛. 的 FDA recently cleared three devices available by prescription. Two of them use electric impulses to stimulate different nerves in the head and scramble pain signals. 的 third uses a magnetic pulse to interrupt brain activity linked to 偏头痛.
"的se devices are for people who can't tolerate medications or who have contraindication to medications,迪格雷说. "Perhaps somebody whois pregnant doesn't want to ingest a medication—one of these devices may help."
老派的建议
It’s important that patients not forget basic health advice like staying hydrated, 均衡饮食, 保证充足的睡眠, 定期锻炼, and learning stress reduction techniques. 的se lifestyle choices can help, Digre says. 她建议病人检查一下 网站 黎明巴士, 博士学位, a University of Utah graduate dedicated to providing free educational materials and resources about 偏头痛s, including downloadable audio files with breathing relaxation and guided visual imagery techniques for pain reduction.
如何获得对你最好的治疗
People who suffer from 偏头痛 should work with their care provider to determine the correct diagnosis and what treatment is right for them. 迪格雷还建议患者：
- 自我教育 about 偏头痛 to better understand their condition and take ownership of it. University of Utah Health's 头痛的学校 covers topics online that are important for people with 偏头痛 and other types of 头疼s. 的 美国偏头痛基金会 also has excellent free information on various aspects of 偏头痛 and cluster 头疼.
- 看专科医生 if treatment doesn’t seem to be working. A specialist can help determine if systemic conditions are contributing to the 头疼s. At 专门的诊所, they can look for red flags and help determine the cause and association of the 头疼 or 偏头痛.
"Migraine is a chronic disease just like diabetes or asthma,” Digre says. “And like other chronic conditions, educational programs and materials are available for patients. We need patients to help us understand the disease of 偏头痛.”