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THE NITTY GRITTYOne of the keys to overcoming a headache is hydration. According to one study of emergency department and inpatient management of both migraines and headaches, adequate fluid hydration and non-opioid medication use should be standard treatment.1 Three good medication options are Zofran, Reglan, and Toradol. Zofran is an anti-nausea medication often used in chemotherapy treatment. It can also help to ease nausea and vomiting associated with headaches. In one study of 120 patients with minor head trauma, Zofran was found to significantly reduce the severity of nausea.2 Reglan is also an anti-nausea medication, used primarily to treat GI issues. In the case of headaches and migraines, Reglan (along with Benadryl) was used to treat patients in an emergency room setting with moderate to severe post-trauma headaches. After IV treatment of the medications, pain scores dropped from 47.5 to 10.9.3 Researchers concluded the treatment was an “effective and well-tolerated medication regimen for patients presenting to the ED with an acute post-traumatic headache.” Toradol, an NSAID, is a potent anti-inflammatory. In one study, Toradol was used to treat acute migraines in 15 patients. After Toradol treatment, pain scores decreased from 4.07 to just 0.73 in two hours.4 Additionally, no side effects were reported. In addition to medications and hydration, B vitamins are also known to reduce headache pain. B2 (riboflavin), when taken in high doses, has been shown to prevent migraines.5 B6, in particular, supports the neurotransmitters serotonin and norepinephrine, both of which are thought to play a role in migraines. B12 deficiency is associated with increased headache severity and frequency. Additionally, one study found that intranasal administration of B12 resulted in a 50 percent reduction in migraine frequency.6 Additionally, B vitamins work to reduce homocysteine. Research not only shows that increased levels of homocysteine can lead to migraines, but that the use of B6, B12, and folic acid can reduce the severity of migraine with aura.7-8 By using a combination of hydration, B vitamins, and targeted medications, you can have your headache under control and your pain a thing of the past.
References: 1. Rozen TD. Continuum (Minneap Minn). 2015 Aug;21(4 Headache):1004-17. 2. Zamani M, et al. Emerg (Tehran). 2015 Fall;3(4):137-40. 3. Friedman BW, et al. Am J Emerg Med. 2018 Feb;36(2):285-9. 4. Shrestha M, et al. Arch Intern Med. 1996 Aug 12-26;156(15):1725-8. 5. Boehnke C, et al. Eur J Neurol. 2004 Jul;11(7):475-7. 6. Van der Kuy PH, et al. Cephalalgia. 2002 Sep;22(7):513-9. 7. Shaik MM and Gan SH. Biomed Res Int. 2015:469529. 8. Lea R, et al. Pharmacogenet Genomics. 2009 Jun;19(6):422-8.