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HeadWay, Issue #162 -- The Migraine Action Plan
February 21, 2018
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In this issue:

The Migraine Action Plan

Say what?! CGRP


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The Migraine Action Plan

This month in the journal Headache, researchers from the USA published a recommended "Migraine Action Plan" (MAP). It's a useful tool for doctors and patients, and you can adapt the idea for your own use today.

Currently the MAP can be viewed online here Migraine Action Plan (MAP) 2018, but we'll look at the overall idea here briefly.

The MAP is simple - only two pages, only four parts.

First, headache information. What is your most recent diagnosis? Do you take preventative medications? What are they?

Next, your plan for home treatment. First, the recommendation to get hydrated and find a cool, dark room to rest in, if possible.

What medications and treatments does your doctor recommend? You might take one medication right away, and another (the same or different) later if you're still in pain. You can list side effects and doses for each medication.

Next, the hospital treatment plan. The MAP lists reasons why you should go to emergency (such as new headache symptoms, or risk of dehydration).

Next, there are common treatments that can be tried at the hospital. The beauty of this is that you can show this document to the doctor at the hospital, and make note of what she uses for treatment.

The MAP also includes a section of medications to avoid, that is, medications that have special risk of prolonging or making symptoms worse over time (such as opiates and butalbital containing meds).

Now, you may not agree with everything in this document (although it is very well done and evidence based), or you may know something that works better for you.

But whether you use the actual MAP or not, making your own is a brilliant idea. It can be useful for friends and family who may need to help you when you're experiencing severe symptoms. And it can be helpful for you when you can't think straight.

I encourage you to talk to your doctor about making your own MAP, whether based on this one or not. Make it simple, step-by-step, and customized for your condition and treatments. Print a copy, and keep a copy on your computer that can be edited. It can be a big help.

Related ideas:

Say what?! CGRP

There's a lot of talk these days about CGRP inhibitors, a new class of migraine medication that is emerging. But what's a CGRP?

CGRP stands for calcitonin gene-related peptide. Peptides (in this case, neuropeptides) are short chains of amino acids, like proteins, but the chains are usually shorter.

CGRP occurs naturally in the body. It has a number of functions, some related to the sending of pain messages, and some in the regulation of blood vessels. So far, it seems that decreasing CGRP levels, which may be too high in migraine patients, can help fight migraine symptoms. Drugs such as triptans may work because of the way they affect CGRP, but more targeted drugs are on the way.


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