Q: My doctor has prescribed medication that seems to relieve the pain when I have a migraine headache, but lately attacks have occurred with increased frequency and are more severe. Do you have any suggestions that might help?
A: The management of migraine headaches involves two distinctly different goals. The first is to prevent attacks; the second is to treat headaches when prophylactic measures fail.
The initial step in the prevention of attacks is to try to recognize and avoid factors that may trigger your attacks. Foods that may provoke migraine include chocolate, ripened cheese, citrus fruits, sauerkraut, sausages, yeast and meat extracts, monosodium glutamate, excessive coffee use and alcoholic beverages, especially red wines. It is not necessary to eliminate all of these foods from your diet, but rather to assess whether consuming any of them seems to provoke attacks. Many other factors may initiate migraine headaches in some people. Among these are sensitivity to particular odors like cigarette or cigar smoke, gasoline fumes, paint, perfumes, after-shave lotions and fragrances added to various toiletries. Attacks may also be provoked by psychological stress, irregular or inadequate amounts of sleep, exposure to bright light and the use of some common medications.