Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (or NSAIDs) are considered a second-line preventative treatment for migraine. They are often recommended when preexisting health conditions make first-line treatments inadvisable, or when first-line treatments just aren't effective. They may also be useful to those who can't tolerate the side effects of antiepileptics, beta-blockers, and antidepressants.
For women who suffer from menstrual migraine, NSAID drugs are highly effective. The drugs are usually started about seven days prior to the start of the menstrual period and taken two to three times daily, depending on the drug and dosage.
Triptan drugs aren't typically used for the prevention of migraine — except in the case of menstrual migraine, where triptans have shown some efficacy as migraine prophylactics. Published studies of naratriptan (Amerge) and frovatriptan (Frova) show the drugs can prevent menstrual migraine in many women.
NSAIDs used for migraine prevention include aspirin (or ace-tylsalicylic acid), naproxen sodium (Aleve), and ibuprofen (Advil). Although many NSAIDs are sold as over-the-counter drugs, you should work with your health care provider to determine what kind and dosage of the medication is best for your particular situation.
Some NSAIDs can increase your sensitivity to the sun, so avoid prolonged sun exposure and use sunscreen when taking them. Other side effects associated with NSAIDs include fluid retention (edema), nausea, vomiting, diarrhea, heartburn, and fatigue.
Taking NSAIDs with alcohol can increase your chance of stomach bleeding and should be avoided. If you take lithium, methotrexate, or any diuretics, NSAIDS can impact the therapeutic action of these drugs. Check with your doctor about the possible interaction of NSAIDs with other medications or supplements you are taking.
If you have stomach ulcers, asthma, heart disease, or kidney or liver problems, certain NSAIDs can aggravate these conditions. Any-one with an allergy to aspirin or to an NSAID should not take these drugs. Aspirin itself or nonaspirin salicylates should never be used in children or teenagers who have flu-like or viral symptoms because it can increase the risk of developing Reyes Syndrome, a rare but potentially fatal disease that can cause serious damage to the liver, brain, and other organ systems.
Because NSAIDs inhibit platelet function (decrease the ability of the blood to clot), they should be avoided in people who take other blood-thinning drugs (anticoagulants) or who are scheduled for surgery.
