Migraines are characterized by pain on one side usually over the eye or cheek, nausea or vomiting, and sensitivity to light. Most migraines last from two to four hours and occur primarily in women. During migraines, blood vessels in the brain experience a sterile inflammation and spasm. This activity occurs at the point where nerves from pain centers connect to the blood vessels.
Researchers believe that a brain chemical, called substance P, regulates the inflammation.
So far, we don't have medications to attack substance P directly. Knowledge of a patient's migraine history is essential for determining which medication to prescribe. Patients with little warning need something that works quickly. Medication choices include Imitrex, which comes in injectable, nasal and pill forms, a nasal spray Migranal, and oral medications Zomig and Amerge. Two more pills are awaiting FDA approval.