Migraines
Treatment & Medications
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Migraines key facts
The exact cause of migraines is not known, but genetics are thought to play a role. Other factors are thought to include stress, hormonal changes, foods, sleep, and environmental factors. Migraine often appears as a severe and throbbing pain down one side of the head. Here, we will take a closer look at the causes, symptoms, and treatments available.
Common symptoms of migraine
Symptoms of migraine vary from person to person, but common symptoms include moderate to severe head pain that may throb. Other symptoms include feeling sick, and sensitivity to loud noises, light and smells. The pain from migraines also becomes worse with physical activity.
Migraine attacks consist of four separate phases. These are known as prodrome, aura, headache, and postdrome. Not everyone will experience each phase, and the length of time of each phase may also vary.
Prodrome symptoms
These symptoms occur before a migraine attack and serve as an early warning sign. Symptoms include:
- Tiredness
- Food cravings, changes in appetite, increased thirst
- Mood changes
- Bloating, constipation, or diarrhea
Aura symptoms
These occur before or during a migraine attack. Neurological symptoms may include:
- Visual disturbances, such as flashing lights or bright lights
- Pins and needles
- Dizziness
- Difficulty speaking
- Changes in smell, taste, or touch
Headache Phase Symptoms
This is the most recognizable phase. Symptoms include:
- Intense, throbbing migraine headaches, normally on one side of the head
- Sensitivity to light and sound
- Feeling sick or being sick
- Pale clammy complexion
- Tiredness
- Difficulty concentrating
Postdrome symptoms
Postdrome symptoms (migraine hangover) follow a migraine attack, symptoms include:
- Feeling tired or irritable
- Muscle pain or weakness
- Food cravings
- Lack of appetite
Causes and other migraine triggers
The cause of migraines is not fully understood, but is thought to be both genetic and environmental. Migraine attacks may be spontaneous, run in families, or have triggers such as stress or hormonal changes.
Risk factors and demographics
Women are three times as likely to suffer from migraines, with changes in the balance of hormones during menstruation influencing the frequency and severity of the migraine attack. Those with a family history of migraines or other medical conditions such as depression, epilepsy or anxiety, may also be more likely to develop migraines.
Types of migraine
There are many types of migraines, with their own specific symptoms. The most common types include:
- Migraine without aura (common migraine): Symptoms include severe headache without any warning signs or visual disturbances
- Migraine with aura: Symptoms include warning signs, such as visual disturbances (flashing lights), pins and needles, dizziness, and difficulty speaking
- Silent migraine (migraine aura without a headache) presents with aura symptoms but without headache pain
- Menstrual migraine: This is affected by hormonal changes, and occurs in women before, during, or after their periods
- Vestibular migraine: Symptoms include problems with balance, dizziness, nausea and vomiting, with or without a headache
- Abdominal migraines: These mainly affect children, causing stomach pain, nausea, and vomiting
- Hemiplegic migraine: This may cause temporary paralysis down one side of your body
- Retinal migraine (ocular migraine): This may cause temporary, partial or complete loss of vision, with a dull ache behind the eye that may spread
- Chronic migraine: This type of headache lasts for at least 15 days each month
- Migraine with brainstem aura: Symptoms include dizziness, loss of balance, slurred speech and double vision, before the headache
- Status migrainosus: This is more rare and severe and can last more than 72 hours
Migraine treatment options
There is no cure for migraines, but several treatment options are available. Options are acute (immediate relief during an attack) and preventive (reducing the frequency and severity of migraines).
Acute medications
Acute treatment is used to relieve pain and symptoms during a migraine attack. Common acute migraine medications include:
- Over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen and acetaminophen for the relief of mild to moderate migraine pain
- Triptans (such as rizatriptan or sumatriptan) that narrow blood vessels and reduce inflammation in the brain. These are available as oral tablets, nasal sprays, or injections
- Anti-nausea medications, such as metoclopramide, used to relieve nausea and vomiting
Preventive measures for migraine
Preventive treatment reduces the frequency, severity, and duration of the migraine by treating the underlying causes. Preventive medications include:
- Beta-blockers, such as propranolol (also used to treat high blood pressure) work by relaxing blood vessels
- Antidepressants, such as amitriptyline, that work by changing neurotransmitter levels in the brain
- Anti-seizure medications, used to treat epilepsy are effective in preventing migraines
Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies
These are a newer class of preventive medications that work by blocking the action of CGRP. They are injected once a month or every few months, depending on the medication.
Non-medication treatment approaches
As well as medication and lifestyle changes, complementary therapy may also play a role in the management of migraines. Speak to a healthcare professional for further advice.
- Biofeedback, which helps gain control over heart rate and muscle tension
- Relaxation techniques, such as meditation
- Cognitive-behavioral therapy (CBT) to identify and change negative thoughts and behavior
- Avoiding certain foods, such as cheese, caffeine, alcohol, and foods containing monosodium glutamate
- Exercise, to promote the release of natural pain-relieving chemicals, such as endorphins in the brain
- Magnesium supplements, which have been shown to provide some benefit when used in combination with other treatments
- Acupuncture
Migraine in women
Many women experience migraine attacks before, during, or after menstruation, during pregnancy or menopause. Understanding how hormonal changes can affect migraines may help with the management of migraine symptoms in women.
Conclusion
Understanding the causes, symptoms, and treatment options for migraines, can help you take the necessary steps to manage your symptoms more effectively. Speak to a healthcare provider for medical advice and to discuss what the best treatment options are for you.
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Service Guide
Everything you need to know about Getting Treated Privately
What does the Get Treated Privately service do?
The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.
Is this a safe service?
Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.
What is a prescribing clinician and is it safe for me to use them on the NowPatient platform?
Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.
Is the service available worldwide?
Yes, the Get Treated Privately service is available worldwide.
Do I need to pay for this service?
Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.
How do I book a consultation?
Once you have logged into your account, you will need to navigate to the Get Treated Privately quick action widget which is located at the bottom of your dashboard. You can then select one of the following actions – ‘Search Treatments’ or ‘Search Conditions’.
Depending on the search type, you will be taken to a consultation booking screen. You will then need to select a date and time that is convenient for you, along with the preferred language of the prescribing clinician you wish to choose. You will then see a list of all available clinicians. From this list, you can filter clinicians by gender and then select the clinician you would like to confirm for your booking.
Once you have approved this, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification and email reminding you of your consultation, 30 minutes before it is due to start.
You can ‘star’ the Get Treated Privately quick action widget to have it display in the ‘My Favourite Widgets’ section of your dashboard, for ease of future booking or checking active or past orders.
What happens during the remote video consultation?
During the consultation, the clinician will ask you a series of questions that will allow the clinician to diagnose your health condition and consider possible treatment options. At the end of the consultation, the clinician will decide if a treatment plan is a safe and appropriate option for you.
If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your ‘shopping cart’ at the end of the consultation.
Also, with your consent, the clinician may wish to inform your GP of the treatment that was prescribed. We recommend that you agree to this since your GP is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.
What happens at the end of the consultation?
At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise if any referrals were made to your GP, along with any other advice that was given to you by the clinician.
If a GP referral letter was issued, you will be able to view a copy of this in the ‘My Documents’ section of your dashboard.
If you were prescribed a treatment plan, it will now be available in your shopping cart. When you go to your shopping cart, you will be able to checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.
What if the prescriber does not prescribe what I want?
We operate a safe and effective service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a service where you can demand a certain medication. If you are not prescribed anything, then you will not be charged.
Will I get status updates for my order?
Yes. When you place an order with NowPatient, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in your ‘My Notifications’ section on your dashboard. You can click the notification and it will take you to your active orders screen which will give you a timeline overview of the progress of your order. This can also be accessed using the ‘My Orders’ quick action widget which is on your dashboard. Here, you can access active and past orders.
How will my order be delivered?
All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour). For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.
For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.
Do you ship cold-chain or temperature sensitive products?
Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.
Learn more about how we handle the delivery of temperature sensitive products.
Where do you deliver?
We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.
When will my order arrive?
- UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
- Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
- Worldwide – Royal Mail – Typical delivery of 5-7 working days
- If a tracked option is available for your country via Royal Mail, this service will be applied.
What should I do if my order has not arrived?
Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘My Notifications’ section of your dashboard, at any point after dispatch.
Unfortunately, packages can sometimes get lost in the delivery system, if after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.
Can you prescribe GLP-1 weight loss injections?
Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.
You can learn more on our Weight Loss Programs feature page.
About Telehealth
Everything you need to know about video consultations
Are remote video consultations right for me?
How do I know if the remote video consultation service is safe?
Do I need to verify my identity during the remote video consultation?
Can I have a chaperone (carer, friend, family member) join a remote video consultation?
How can I be sure that you are handling and protecting my data securely?
How is my data stored?
Are my consultations confidential?
Can I select which clinician I have my consultation with?
Will my doctor be informed of any consultations I have through the app?
Do remote video consultations save money for health systems?
Are remote video consultations safer than online questionnaires?
What quality of care can I expect to receive from a remote video consultation?
WHY WE BUILT NOWPATIENT
We are committed to helping everyone, everywhere live healthier lives
The NowPatient virtual care platform provides you with access to trusted health information, affordable treatments, management of chronic health conditions and continuous monitoring for health risks. NowPatient can be accessed by downloading the App or using your web browser.
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What does NowPatient do?
NowPatient is an online pharmacy & telehealth service that is available in the US and UK. Our service is FREE and packed with useful features that can help you save money on the cost of your medications, access virtual treatments, and provide tools that can help improve your overall health.
Get started today and benefit from medication reminders, Get Treated Privately, NHS online pharmacy, GP appointment booking, Rx savings card, Drug Coupons, US drug savings programs, health conditions information, genetic testing, home test kits, BMI Risks, Type 2 Diabetes Risks, pollen meter, air quality monitor, and lots more!
Our service is operated by experienced medical professionals in the United States and the United Kingdom. You can view the online services that we provide by clicking Features.
UK users can safely and securely buy medicines online that treat a wide range of medical conditions. UK customers can also order NHS prescriptions online with the benefit of free tracked delivery.
US customers, regardless of insurance coverage, can enjoy huge savings on prescription medications using our various drug savings programs including drug coupons, savings card and manufacturer-sponsored patient assistance programs.
Where is NowPatient located?
NowPatient has offices in the United Kingdom and United States.
In the UK, we are located at:
NowPatient
28 Chipstead Valley Road
Coulsdon
Surrey
CR52RA
In the US, we are located at:
NowPatient
8911 North Capital of Texas Highway
Suite 4200 #1263
78759
Austin, TX
How can I contact NowPatient?
To contact NowPatient, please use the contact form available on the Contact Us page.
Alternatively, if you need to speak to us, you can reach us on the following numbers:
UK telephone number – 020 388 51 500
US telephone number – 1-866-967-1977
Who owns NowPatient?
NowPatient is owned and operated by Infohealth Ltd, a licensed online pharmacy with services spanning the UK, US and Rest of the World. Infohealth Ltd is registered in England and Wales under company number 04004930 and our registered office is at Lynwood House, 373 – 375 Station Road, Harrow, England, HA1 2AW.
Our website is www.nowpatient.com. Our App is called “NowPatient” and can be downloaded from the App Store (for Apple devices) or Google Play (for Android devices).
Can you tell me more about your NHS online pharmacy?
NowPatient’s Pharmaceutical services in the UK are provided by Infohealth Limited trading as ‘Infohealth Pharmacy’.
Our dispensing pharmacy is regulated and authorized for internet sales by the General Pharmaceutical Council (GPhC), registration number 1036487. You can view our license credentials on the General Pharmaceutical Council website. Our superintendent pharmacist who is responsible for the safe and effective oversight of medicines supplies is Mr Amish Patel (Registration Number 2042705).
Medicines are not ordinary items of commerce. All medicines or healthcare product sales are made under the supervision of a registered pharmacist who is licensed by the GPhC. At all times, we endeavour to provide a professional and transparent service whose primary goal is to ensure that the best interests of the patient are served.
How do I make a complaint?
From time to time, we accept that our service levels may not be up to your expectations. NowPatient welcomes concerns, compliments and complaints as valuable feedback that will help us learn from your experiences and make improvements. Feedback can be provided via our clear and transparent Complaints Procedures.
Can you tell me more about NowPatient’s prescribing services for treatments offered?
Our prescribing services are regulated by the General Pharmaceutical Council (GPhC). We provide the following regulated activity:
• treatment of disease, disorder, or injury
• transport services, triage, and medical advice are provided remotely
• caring for adults over 65 years old
• caring for adults under 65 years old
NowPatient prescribing services are run by Infohealth Limited. The Clinical Safety Officer and nominated individual is Mr Navin Khosla.
Can you tell me more about NowPatient’s US services?
Our head of US services is Dr. Jamie Winn.
You can lower the cost of your prescription medications using our various savings programs which include drug coupons, savings card and manufacturer-sponsored patient assistance programs.
We do not provide any prescribing services or dispensing services in the United States.
Is NowPatient legit and can I trust information from NowPatient?
Yes. NowPatient provides trustworthy and accessible clinical, health education and prescription services. We are also trusted by the NHS to deliver clinical and NHS repeat prescription dispensing across the whole of England. In the United States, we work with over 65,000 pharmacies to deliver considerable costs savings for our users.
NowPatient is operated by experienced licensed medical professionals in the United Kingdom and United States. Our Medical Team can be found here.
Our service is trusted by thousands of patients worldwide. You can read their reviews on our Trustpilot:
What are NowPatient’s opening hours?
Our office hours are:
UK – Monday-Friday 9am-6pm GMT
US – Monday-Friday 8am-5pm EST
Please note that we are closed at weekends.
In the event of a medical life-threatening emergency please call:
UK – 999
US – 911
In the event of a medical emergency which is not life-threatening please call:
UK – 111