Every minute with a migraine headache can be excruciatingly painful. Unfortunately, as migraine sufferers know, migraines can last a very long time, and they're not always responsive to painkillers and other medications. As a result, the best option for people who suffer frequent or severe migraines is usually to try to prevent the migraines. While prevention isn't always effective either, there are a number of things you can do that have been proven to reduce the severity and frequency of migraines in many people.


Steps

1. Keep a headache diary. The exact causes of migraines aren't clear, and migraines seem to be triggered by a wide variety of different things. While this article deals with some of the more common triggers, there is no substitute for knowing what triggers your migraines. A headache diary can help you determine this, and it can also help you and your doctor monitor the effectiveness of treatments.
2. Recognize the early warning signs of a migraine. Many migraines are preceded by certain symptoms, called prodrome symptoms. Taking special care to relax and to avoid potential triggers when you notice these signs may prevent an impending migraine or lessen its severity. It's also important to try to keep a positive attitude if you notice these symptoms, as the additional stress and anxiety can worsen the migraine. Symptoms include:
   
   
   • Visual disturbances: About a third of migraine sufferers experience migraine with aura, a condition in which the migraine headache is preceded by visual disturbances, including the appearance of flashing lights, blind spots, or "snowy" vision. The aura may also manifest itself as tingling or numbing sensations in the skin or in the form of auditory disturbances.
   • Mood changes, including depression, euphoria, and irritability
   • Increased thirst and/or fluid retention
   • A marked increase or decrease in appetite
   • Sensitivity to light and sound
   • Fatigue or restlessness
   • Difficulty communicating or understanding people
   • Stiffness in the neck
   • Feeling dizzy or lightheaded
   • Diarrhea or nausea: these symptoms often accompany a migraine in addition to, or instead of, preceding it.
3. Get into a regular sleep schedule. Too little sleep and too much sleep have both been implicated as migraine triggers. Beyond making sure you get adequate sleep, however, it's also helpful to stick to a regular schedule of when you go to sleep and when you wake up. Disturbances to the sleep schedule seem to trigger headaches in many migraine sufferers.
4. Manage stress. Stress has long been known to trigger both tension headaches and migraines. Managing stress through the use of relaxation techniques, positive thinking, and time management can help ward off migraines. Relaxation and the use of biofeedback have also been shown to help many migraine sufferers treat a migraine that has already begun.
5. Quit smoking and avoid smoke. Tobacco smoke is a trigger for many migraineurs. If you smoke, quit, and if you don't smoke, try to avoid secondhand smoke.
6. Limit your alcohol intake. Alcohol can cause hangovers even for people who don't suffer from migraines. For many migraine sufferers, however, alcohol in general, and beer and red wine in particular, can trigger headaches, nausea, and other migraine symptoms that last for days. Some migraine sufferers find that alcohol doesn't affect them at all, while others can't tolerate even a little bit. Make use of your headache diary to determine your threshold, and be wary of crossing it--avoid alcohol completely if need be.
7. Eat regularly. Skipping meals seems to trigger migraines in many people. Try to eat several small meals and snacks throughout the day or to at least make sure you get three meals daily. Taking these meals at the same times each day may also help.
8. Control your exposure to intense stimuli. Bright or flashing lights can sometimes precipitate migraines. Wear sunglasses on sunny days, and rest your eyes periodically when watching TV or using your computer. Non-visual stimuli, such as strong scents, can also precipitate migraines in some people. Once you've been exposed to a certain scent (whether it be paint fumes or a certain cologne) that seems to trigger a migraine, try to avoid that scent.
9. Avoid caffeine. Caffeine is one of the most commonly-suspected migraine culprits. Like all the other possible triggers, however, it affects some people significantly and others not at all. If you regularly use caffeine and suspect it may be causing migraines, you may want to wean yourself off it gradually, as caffeine withdrawal also seems to precipitate migraines. To further complicate the matter, some people find that if they drink a cup of coffee at the first sign of an impending migraine they can reduce the severity of the symptoms or stop the migraine altogether.
10. Exercise. Regular exercise seems to reduce the frequency of migraines for many people, possibly because it helps reduce stress. Sudden or strenuous exercise, however, has also been implicated as a migraine trigger, so don't overdo it. In addition, warm up slowly, and make sure you're well hydrated before and after exercise. Avoiding exercise in particularly hot or cold conditions may also help.
11. Identify possible food triggers. Many migraine sufferers report that certain foods trigger their migraines, but clinical studies on these suspected culprits have turned up no conclusive evidence that they are in fact responsible for migraines. That said, if avoiding certain foods works for you, there's no reason not to try it. Some commonly reported food triggers include chocolate, cheese (particularly aged cheeses), aspartame (an artificial sweetener), processed meats containing nitrates, and foods that contain monosodium glutamate (MSG).
12. Think twice before taking hormonal medications. Many women who suffer from migraines find that they are more likely to develop migraine headaches and nausea before or during menstruation or during pregnancy or menopause, and scientists posit that this may have something to do with fluctuations in the body's estrogen levels. High-estrogen birth control products and hormone replacement therapy may exacerbate the problem for many women, so it may be best to avoid these medications or, if you're already taking them and notice an increase in the severity or frequency of migraines, to stop using them.
    
    
    • Some women find that these medications actually reduce the occurrences of migraines. Others find that migraines are triggered only when skipping a week of the pills, as is common practice with many contraceptives. Talk to your doctor about possible solutions to these problems.
    • Women whose migraines tend to correspond with menstruation may find that certain over-the-counter medications prevent or reduce the severity of migraines. Take 220-440 mg of naproxen (Aleve) every 12 hours or 400-800 mg of ibuprofen every 8 hours, starting 2-3 days before your migraine usually sets in and continuing until your period is done.
13. Take prophylactic medications. If you suffer from frequent or severe migraines, ask your doctor whether prophylactic (preventative) medications might help. These medications are available only by prescription, and many of them have possible serious side effects, so they should only be used under a doctor's supervision. The sheer number of different medications, combined with the fact that every migraine case in is many ways unique, means that finding the right combination of medicines for migraine prevention can take a while, especially since it can take several weeks to evaluate a particular drug's effectiveness. Several drug classes have been found to be effective for many migraine sufferers:
    
    
    • Cardiovascular medications, including beta blockers (e.g. propranolol and atenolol), calcium channel blockers (e.g. verapamil), and anti-hypertension medications (e.g. lisinopril and candesartan).
    • Anti-seizure medications such as valproic acid and topiramate.
    • Antidepressants including tricyclic antidepressants (TCAs) such as amitriptyline and the newer selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) have proven effective in many cases.
    • Cannabis is a traditional migraine remedy that has sparked renewed scientific interest. It's illegal in many jurisdictions, but is available by prescription in others and is legal and uncontrolled in a few places.
14. Take non-prescription supplements. Prescription drugs aren't the only prophylactic remedies that have been shown to reduce the severity and frequency of migraines in some people. Certain herbs and minerals have also shown promise in warding off migraines. Keep in mind that you should always consult with your physician before taking any herbal or nutritional supplements, especially if taken in conjunction with prescription medications.
    
    
    • Magnesium: Researchers have found fairly strong correlations between magnesium deficiency and the onset of migraines, and some studies have found suggest that regularly taking magnesium supplements may be beneficial for migraine sufferers. Oral magnesium (600 mg per day of trimagnesium dicitrate) was found to reduce the number of migraines by as much as 40% after several weeks. Ask your doctor before taking any supplements, but as magnesium is cheap and relatively safe, it's often recommended.
    • Several herbal supplements have been purported to reduce migraine frequency, but extracts of the feverfew and butterbur plants, as well as kudzu root seem particularly promising based on clinical studies. These supplements should not be taken by women who are pregnant.
    • At least one clinical study strongly suggests that daily 100 mg supplements of coenzyme Q10 may be as effective as prescription medications in reducing migraine frequency. Fairly high doses of Riboflavin (Vitamin B2) also seem to be effective for some patients.

Tips

• Some migraine triggers, such as weather changes and menstruation can't be avoided. If you're affected by things beyond your control, you may find that being especially diligent in relaxation and the avoidance of other triggers will help.
• Unfortunately, there is no known "cure" for migraines. Even with the use of trigger avoidance and prophylactic medication, migraine sufferers will likely still experience some migraines.
• Migraine triggers are not well understood. While there are many recommendations for foods and activities that you should avoid, the only triggers you need to avoid are the ones that cause your migraines.
• Some headache specialists have reported success in preventing migraines using Botox injections.
• Some people report that acupressure, acupuncture, massage, and chiropractic treatments seem to help control migraines, but there is currently no scientific evidence that suggests these methods are beneficial. Still, they are generally harmless when practiced by a trained professional, so if nothing else seems to work, they might be worth a try.

Warnings

• This article is a general guide and is not intended to substitute for the advice of a medical professional. Consult your doctor before taking any medications or before making any drastic lifestyle changes.
• The symptoms of migraine may also indicate other, more serious, disorders. If you suspect you suffer from migraines, consult your physician for a diagnosis.
• If you are taking over-the-counter painkillers more than half the days of the month, you are at risk for "rebound" headaches if you quit taking these painkillers. Therefore, use aspirin, ibuprophen, etc., only when needed. If you take a daily aspirin to reduce the risk of heart attacks, make sure it is a low-dose (81-mg.) adult aspirin and not a full-strength aspirin, or you put yourself at risk of rebound headaches.