What causes migraines and why do they get so severe?

Question

Hello doctor,

My migraines are destroying my life. I am a 27-year-old and these headaches are ruining my career. Last week, I missed three important client presentations because I could not even look at my computer screen. The pain begins behind my right eye and spreads like a burning web across my skull. I have tried over-the-counter medications, but they feel like candy they do absolutely nothing. My vision becomes so blurry that I can barely distinguish colors during these attacks. My mother suggests that it might be hereditary, but no one in my family has ever described pain as this intense. The noise-canceling headphones are no longer effective, and bright lights feel like daggers. Is there anything that can stop these nightmare headaches? Should I consult a neurologist or a general physician?

Please guide.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for posting your query.

It sounds like you are dealing with severe, disabling migraines, possibly accompanied by visual aura or optic nerve involvement.

If over-the-counter medications are not effective for you, there are alternative treatments available, though you will need a prescription for these:

Triptans such as Sumatriptan, Rizatriptan, or Eletriptan. These are first-line treatments for migraines.
Gepants such as Ubrogepant or Rimegepant. These medications generally have fewer side effects.
Dihydroergotamine is stronger than Triptans and is used for attacks that last longer than 24 hours.
NSAID (non-steroidal anti-inflammatory drug) combinations (e.g., Naproxen combined with a Triptan).

I recommend seeing a doctor who can suggest the most suitable medication for your specific condition.

If your migraines last longer than 72 hours, you may require IV (intravenous) treatments in a hospital setting.

Additionally, you might benefit from FL-41 tinted glasses, which block the specific light wavelengths that can trigger migraines.

For managing your screen time, try using dark mode, and blue light filters, and reduce your screen brightness.

It is also important to avoid neck strain by adjusting your monitor height and taking regular breaks every 30 to 45 minutes.

Ensure that you are getting adequate sleep and try to maintain a consistent sleep schedule.

You can also consider these supplements, which may help with your migraines:

Magnesium (400 mg daily), especially helpful if you experience visual aura.
Riboflavin (400 mg daily), which may reduce the frequency of migraines.
CoQ10 (300 mg daily), which supports brain function.

I also suggest consulting with an ophthalmologist. You may need glasses, or if you already wear glasses, a power adjustment might be necessary.

Please let me know if you want some help.

Thank you.