What is Abortive Therapy, Know Its types, Effectiveness, and Side Effects

What is Abortive Therapy?

An abortive therapy is a treatment used for migraine and other headaches. The target of abortive therapy is to stop headaches and other migraine symptoms, which are nausea and vomiting.

Types of Abortive Therapy

There are many types of abortive therapies for migraines and headaches.

Over-The-Counter Painkillers

Over-the-counter painkillers are the first choice for any type of headache, which includes migraine headache and tension headache. Different types of over-the-counter medicines include Tylenol, aspirin, ibuprofen, naproxen, indomethacin, ketorolac, diclofenac, celecoxib, and ketoprofen. Out of all these indomethacin is the first choice for treating hemicranias continua. Using it can help diagnose and prevent the condition.

Sometimes, combination painkillers are used such as aspirin and acetaminophen.

Triptans

For moderate to severe recurring migraine and cluster headaches, triptans are used. The common triptans are sumatriptan, naratriptan, rizatriptan, zolmitriptan, frovatriptan, and eletriptan.

Injectable triptans are used in the treatment of cluster headaches. They treat the condition rapidly howsoever severe it is.

Ergot Alkaloids

In cases where triptans are ineffective, ergot alkaloids are used. These are basically used for severe migraines. Ergot alkaloids include dihydroergotamine mesylate and ergotamine. They are also used in cases where a person is getting side effects from using triptans.

Lasmiditan

Lasmitidine is an abortive therapy that is recently approved for the treatment of migraines. It works similar to triptan and has fewer side effects on those who have cardiovascular risk factors.

CGRP Antagonist

CGRP or calcitonin gene-related peptide receptors are the newer option of abortive therapy used in the treatment of migraine. It includes drugs such as ubogepant and rimegepant and works by stopping protein involved in pain signaling.

Effectiveness of Abortive Therapies

Most abortive therapies involve taking over-the-counter prescriptions when the symptoms start getting noticed. Their effectiveness depends on the type of medication and the severity of the symptom. In most cases, mild headache can be relieved with over-the-counter medications such as ibuprofen, aspirin and acetaminophen.

A review in current pain and headache reports found that medications like acetaminophen, ibuprofen, and aspirin were effective in relieving the symptoms of mild to moderate headache.(1) A combination of one or more drugs is also found to be effective for milder migraines.

Triptans are prescribed for severe pain. These medications block the pain signals in the brain. These vary in efficacy. A 2014 review found sumatriptan to be effective in relieving head pain and related symptoms in 59 percent of people who were reviewed.(2)

Other types of abortive therapy drugs vary in effectiveness but may be helpful in relieving head pain.

According to the American Headache Society Consensus Statement, abortive therapies are found to be more effective when taken under 15 minutes of the occurrence of symptom or when the pain is mild.(3)

Side Effects of Abortive Therapies

The side effects of abortive therapies depend on the type of drug taken.

Over-the-counter pain killers are known to cause liver damage, indigestion, gastrointestinal bleeding and stomach aches.

Potential side effects of triptans include nausea, chest pain, tingling, dizziness, neck pain and cardiovascular complications.

Ergot alkaloids can cause nausea, vomiting, itching, numbness, weakness, slow or fast heartbeat and muscle aches.

Lasmiditan can lead to dizziness, lethargy, sedation and tingling.

CRGP antagonist may cause nausea, headaches, tingling, dry mouth and vision problems. If any of the side effects are observed, a doctor should be consulted for an alternative.

Abortive therapies are used to stop headaches after they have started. None of the medications in this therapy should be started without consulting a doctor. There can be side effects and it is good to let the doctor decide what is right for you.