Headache Treatment

Migraine & Headache Treatments

Since there are several types of headaches, treatments can include everything from physiotherapy to injectable medication for migraines.

Dr. Schiffer, who has extensive experience in headache and migraine treatment, gives a brief overview of migraine headache treatment in Mississauga and Toronto as follows:

• Avoid common headache triggers, such as chocolate, cheese and red wine. Keep a food diary.
• Use simple analgesics to treat moderate headaches – Advil® and Tylenol® with cola or coffee.

Triptans for Migraine

Talk to your doctor about triptans, a class of prescription medication for specific acute migraine therapy. They shrink and calm inflamed, enlarged blood vessels of vascular headaches. Triptans come in oral as well as nasal and injectable formulations. Some commonly used triptans include FROVA®, Amerge®, MAXALT®, ZOMIG® and Imitrex®. Side effects of these medications include sedation, nausea, tingling and other sensory symptoms, and chest pain, and in rare circumstances cardiac complications.

Preventative Treatments

Consider prophylactic measures to reduce frequency and severity. Such measures include oral medications and herbal remedies such as feverfew, as well as non-medicinal measures such as massage, acupuncture and orthopedic pillows, which can all help in some cases. Oral prophylactic mediations include a diverse list of anti-seizure medications, as well as antidepressants and beta-blockers, such as LYRICA®, TOPAMAX®, valproic acid, Elavil® and nadolol. Each has its own side-effect profile, and there is an element of trial and error as to which medication may benefit a given individual.

There are new injectable preventative medications for treating headaches that have been released in Canada in the last few years. These are drugs designed specifically for migraine treatment called Monoclonal antibodies. They are antibodies created against a specific chemical that is involved in propagating migraines. Treatment involves a self injection once-a-month. At present there are three routinely available in Canada: Erenumab, Fremanezuemab, and Galcanezumab, but more are on the horizon.

A new class of medications is also on the horizon for prevention (and acute treatment) of migraine called the Gepants. There will likely be increasing numbers of treatment options available to patients over the next few years as research in migraine treatment produces more and better options to treat this debilitating condition. 

Treatment for Chronic Migraine

For chronic migraines, defined as 15 days of headache per month, medications that are injected in the area of the head and neck area can be tried, including nerve blocks with cortisol and lidocaine, or injections with botulinum toxin (BOTOX). Side effects of injections can include precipitating a headache or bruising and localized tenderness. Other side effects, such as unintended muscle weakness in the face or neck, which could result in a drooping brow or lid or dysphagia or neck weakness, can also rarely occur after migraine treatment with BOTOX. Mississauga and Toronto migraine patients can find a more detailed discussion of the potential side effects of BOTOX on our page for prescription wrinkle injections.

Many private health insurers will cover the costs involved with headache treatment.

Side effects and contraindications exist for all these options and need to be discussed during a detailed consultation with a headache specialist.

Request Your Consultation

To obtain more information on headache treatments, call our migraine clinic in Mississauga at  (905) 273-3045 or our Toronto migraine clinic at (416) 207-9090. If you require a consultation regarding headaches, please have your family physician fax a referral to our office.