This is not an “anti-drug” post – I fully accept that prescribed medication is the mainstay of migraine prevention. Certain beta-blockers, antidepressants and anticonvulsants are long established for reducing the frequency and severity of attacks, and the newer CGRP inhibitors have even better results. But none of these drugs work for everyone, and all of them can have unwanted side effects. I took propranolol for many years with some benefit, but then its effect seemed to wear off. I then decided to look more closely at what lifestyle factors triggered my attacks, and to explore some complementary therapies that seemed more “natural” and gave me more choice and control over managing my health. Many of the non-drug options for migraine prevention are supported by evidence from clinical trials as well as by anecdotal reports, but the orthodox medical approach tends to focus on drug treatments alone. My new book Migraine and Me: A Doctor’s Experience of Understanding and Coping with Migraine aims to give a more holistic overview. Here is a brief summary of some of the preventive methods it describes. They do not offer a cure for migraine but, whether used alongside drugs or instead of them, they can help. Most of them are relevant to other chronic medical conditions too.  

Being instructed to eat better food, get more sleep, take more exercise, stop smoking, drink less, and reduce stress can be irritating – but these deceptively simple “healthy living” guidelines can make a real difference. There are special considerations for migraineurs such as not going too long between meals, and identifying triggers in the diet and environment.

Dietary supplements which have been found effective include magnesium, B vitamins and Coenzyme Q. The herb feverfew, illustrated, is available in capsule form but the most natural way to take it is by chewing its leaves, as described in one of the case histories in my book.

Relaxation techniques can help by activating the parasympathetic “rest and digest” branch of the nervous system, as opposed to the sympathetic “fight or flight” branch which tends to be overactive in migraineurs. Relaxation is a component of many other therapies such as biofeedback and massage.

 Psychological therapies may be regarded with suspicion because they are thought to imply that migraine is “all in the mind” rather than being a neurological disease with a genetic basis. I am certainly wary of psychoanalytical theories that cite repressed anger or sexual conflicts as being the cause. But more practical approaches such as cognitive behavioural therapy (CBT) can alleviate the mental distress and social difficulties that make it harder to cope with attacks and may well be exacerbating them.

Creative activity through art, music or writing is a way of processing emotions around migraine. If the results are made public, they can contribute to understanding of the condition. Some works by historical figures such as Richard Wagner and Vincent van Gogh are thought to have been inspired by the migraine experience.  

These and other approaches are covered in more detail in Migraine and Me: A Doctor’s Experience of Understanding and Coping with Migraine, available in both print and e-book versions from your local Amazon site and other online retailers. Please forward this post to anyone in your circle who may be interested.