8 Types of Headache Tablets in India: Migraine & ProphylaxisSanjoy
So, in this article, we are talking about the drugs used in migraine or headache tablets in India.
Headache or Migraine:
What is a Migraine?
Migraine is severe throbbing pain or a pulsing sensation usually on one side of the head. It is often accompanied by nausea, vomiting, and extreme sensitivity to light & sound.
What causes Migraine?
There are many theories to explain this fact. However, they’re just theories the older ones suggest.
For instance, the symptoms were due to changes in blood flow to the brain and another aspect of migraine pain theory explains that it happens due to waves of activity by neurons that release serotonin. As a result, it causes abnormal dilatation and pulsation of cerebral blood vessels.
Headache Tablets in India for Migraine:
Now, in case of migraine or headache, what will be our approach to treat the patient. Of course, we’ll try to vasoconstrict the cerebral blood vessels.
There are many groups of headache tablets in India used in migraine. We can use them in two instances.
For example, there are headache tablets in India that are used in acute attacks and then there are drugs that are used for migraine prophylaxis for acute attacks.
There are four classes of drugs used and the same is the case for migraine prophylaxis. Similarly, four types of drugs are used here too.
Types of Headache Tablets in India:
The first types of headache tablet in India are NSAIDs. They’re used in mild and moderate migraine. However, we do not give them for the long term because of the side effects.
Side effects include hypoprothrombinemia which interferes with the action of vitamin K in the liver and sodium. Also, water retention is due to prostaglandin inhibition.
Examples are aspirin, ibuprofen, mefenamic acid, et cetera.
The second choice is to use antiemetics. These headache tablets in India are used to treat nausea and vomiting associated with migraine attacks. They can be given intravenously or orally.
They are mainly 5-ht for antagonists and h1 blockers. We know that 5ht4 is present in the gastrointestinal tract serotonin receptor by blocking this vomiting and h1 blocker is present in the chemo trigger zone and vestibular apparatus which also decreases vomiting by blocking them.
Thirdly, we can use certain headache tablets in India known as ergot derivatives or ergot preparations. They are mainly used at the onset of pain in moderate to severe migraine.
They can be given orally, sublingually, or as a suppository. The ergot preparations are mainly partial agonists at 5HT1B/1D.
In fact, they are the partial agonists at all the 5ht1 receptors. But as 5ht1 are autoreceptors, they decrease certain releases and also constrict cerebral blood vessels, decrease inflammation and decrease extravasation of fluid. These were the main actions of ergot.
But there is another drug in this class which is dihydroergotamine which is safer for parenteral use. It is because it’s the alpha-blocking effect is more than its smooth muscle contraction effect. Hence, it does not cause the side effects which are associated with our gut. It means our GI distress, diarrhea, gangrene, and abortion.
It is mainly given with caffeine due to its beneficial effects such as absorption is increased. Also, the visual constructive effect of caffeine.
Lastly, the headache tablets in India used for acute management of migraine are triptans. They are selective agonists at 5ht1b and 5ht1D receptors.
For example, Sumatriptan, Almotriptan and Zolmitriptan. They are used in moderate and severe migraine.
They help in migraine by 3 mechanisms. Because of cerebral ischemia, some theory suggests the cerebral ischemia caused the attack. So, they constrict the dilated blood vessels and restored the blood flow. They also decrease the rotten release because they are agonists of the autoreceptor. Also, decrease the extravasation of plasma proteins into the vascular space.
Headache Tablets in India for Prophylaxis:
Now, the drugs used for migraine prophylaxis include beta-blockers such as propranolol. They’re used chronically. Their mechanism is unknown but maybe their mechanism is due to the beta 2 blockade without which beta 2 causes visual dilation.
DCA’s tricyclic antidepressants like amitriptyline are also used. However, they should not be used for prolonged periods.
Calcium channel blockers such as Verapamil and Flunarizine are also used. Flunarizine is preferred because it is selective for cerebral calcium channels.
They should not be given with beta-blockers. Maybe they help with the pulsation of the cerebral blood vessels.
Anticonvulsants such as gabapentin and sodium valproate are also used for migraine prophylaxis. They stabilize the neuronal membrane by a sodium channel blockade. So, there is no repetitive and action potential. And, there is decreased serotonin release.
In the conclusion, there are 8 types of headache tablets in India used to treat various types of headaches, i.e., acute migraine attack and migraine prophylaxis. Here are all the types and some examples of headache tablets in India.
Acute Migraine Attack:
- NSAIDs: Aspirin, Ibuprofen
- Antiemetics: Metaclopramide
- Ergots: Ergotamine
- Triptans: Sumatriptan, Almotriptan, Zolmitriptan, etc.
- Beta-blockers: Propanolol
- TCAs: Amitriptyline
- CCBs: Verapamil and Flunarizine
- Anticonvulsants: Gabapentin and Sodium valproate