How can you prevent migraines?

 Migraines can significantly reduce your quality of life and unfortunately cannot be cured, but you can try to prevent or alleviate an attack. You have the choice: with medication or without.

Without medicines

• One of the best ways to prevent migraines is to recognize the factors that trigger an attack and then avoid them. For example, you may notice that you get migraines after eating a certain food, if you skip a meal or if you are stressed. What may help identify triggers is keeping a diary with information such as date and time of the attack, warning signs, symptoms, medications you were taking,...
  
• If you have migraines, it is in any case a good idea to adjust your lifestyle: keep a regular sleep pattern , eat enough and balanced at regular times, stop smoking , exercise three times a week for 40 minutes...
  
• Biofeedback (devices that measure body signals with sensors) and/or relaxation therapies (such as massage therapy or physical therapy) or acupuncture can also be useful if you want to avoid medication.
• Through cognitive behavioral therapy, you can learn certain strategies that help you deal with problems and stress , as well as the migraine symptoms themselves.
• Some vitamins and minerals can help relieve migraine symptoms: coenzyme Q10 (CoQ10), magnesium , riboflavin, vitamin B2, ginkgo biloba, omega 3 , vitamin C , and vitamin D.
• With the cefaly device you could reduce the pain during a migraine attack or even prevent an attack. It's an electronic device that generates electrical impulses through an electrode that you stick on your forehead

With medicines

• During a migraine attack you can take paracetamol or an anti-inflammatory, possibly combined with an anti-emetic. If these medicines do not work enough for the pain, you can ask your doctor to prescribe specific migraine medication (triptans). 
  
• You can also try preventative treatment in the form of beta-blockers, anticonvulsants, or antidepressants . You should take these medicines every day for a period of at least three months to see if they have an effect. If the treatment is successful, you will experience fewer migraine attacks and the severity of the attacks will also decrease.
• Botulinum toxin is an option for chronic migraines. This substance is injected subcutaneously at the height of the forehead, both temples, the back of the head, the neck and the shoulders. Certain neurotransmitters that are released during pain are blocked in this way. In Belgium, the medicine is partially reimbursed, but only if other treatments prove unsuccessful.
• A group of drugs that have been specifically developed against migraine are the CGRP inhibitors. These agents target the CRGP protein that would be elevated during a migraine attack. This can reduce the number, severity and duration of migraine attacks. In our country, Aimovig® (Novartis), Ajovy® (Teva) and Emgality® (Eli Lilly) are reimbursed for adults with at least 8 migraine days per month and at least 3 previously failed prophylactic treatments.