Category: California

While the physical effects of acute stress typically subside once the stressful situation has passed, chronic stress — the kind that continues for months or years — is more likely to lead to serious illness.

The stress hormones cortisol and epinephrine (adrenaline) “affect most areas of the body, interfering with sleep and increasing the risk of stroke, high blood pressure, and heart disease as well as causing depression and anxiety,” says Alka Gupta, MD, chief medical officer at Bluerock Care in Washington, DC.

Here are a few key ways chronic stress can impact the body:

One possible culprit: Chronic stress seems to be linked to an increase in pro-inflammatory cytokines, a type of immune cell that is typically part of the body’s defense system when you have an infection. But when these cytokines are chronically activated, as with stress, they can lead to ongoing, low-level inflammation.

Digestive Disorders “The gastrointestinal tract is filled with nerve endings and immune cells, all of which are affected by stress hormones,” says Dr. Dossett. As a result, stress can cause acid reflux and exacerbate symptoms of irritable bowel syndrome and inflammatory bowel disease — not to mention that it can create butterflies in your stomach.

Changes in Brain Function “Brain scans of people with post-traumatic stress disorder show more activity in the amygdala, a region of the brain associated with fear and emotion,” says Haythe. But even everyday kinds of stress can affect how the brain processes information.

Poor Sleep They’re also less apt to sleep well, which doesn’t help matters. “Sleep is so important in terms of helping to prevent every disease,” adds Haythe. “It helps reboot the immune system and prevents depression, irritability, and exhaustion.”

“This is the right decision and matches recommendations from other countries to protect against toxicity and future health harms. Overall, it is one small step amidst a larger need to make our food supply safer for the most vulnerable, such as young children,” says Sheela Sathyanarayana, MD, a professor of pediatrics at the University of Washington and an investigator with the Seattle Children’s Research Institute.

What Is Red Dye No. 3 and How Does It Impact Our Health?

FD&C Red No. 3, also called Red 3 and erythrosine, is a synthetic food coloring made from petroleum that is used to give foods and drinks a bright red cherry color.

Scientists believe Red 3 causes a hormonal reaction specific to male rats that results in cancer. But later animal studies didn’t find any cancer link, and there’s no evidence showing that Red No. 3 causes cancer in humans.

What Foods Contain Red Dye No. 3?

• Seasonal candies: Valentine treats like “conversation hearts,” cherry cordials, and other candies including PEZ, Fruit by the Foot, Hot Tamales, Dubble Bubble gum, candy corn, and ring pops may include Red 3.
• Maraschino cherries: Some companies have made the switch to Red 40, but the cherry industry is the largest user of Red 3–dyed products in the United States and Europe.
• Fruit cocktails: Some common brands of canned or packaged fruit medleys use cherries dyed with Red 3.

The dyes can also be found in some strawberry-flavored milks, sodas, vegetarian meats, ice creams, and desserts.

Why the FDA Finally Banned Red Dye No. 3

Red Dye No. 3 Ban Is a Good Thing for Consumers

The ban is a long overdue decision from the FDA, says Kate Donelan, RD, a registered dietitian with Stanford Health Care in California.

“It’s certainly positive to eliminate unnecessary risks, especially as there are safer, natural coloring agents like beet juice or paprika extract that can have the same impact as Red Dye 3 without the potential for harm,” she says.

Regulation makes it easier for people to avoid potentially risky additives, says Dr. Sathyanarayana.

“Often, consumers are left with the burden of deciding what food products to buy, without significant knowledge of health harms. This creates confusion and anxiety for those who are trying to make positive decisions for household meals, but are left with endless choices,” she says.

FDA Move Reflects Growing Public Concern About Food Additives

“People are waking up to the much more lenient food policies here in the United States compared with the EU, where stricter regulations have been the norm for years,” says Donelan. “We need to expand this critical eye to other artificial additives with questionable safety profiles, such as Red Dye 40 or Yellow 5,” she says.

Sathyanarayana agrees. “This is one positive step, but there is so much more to do to make our food supply safer and healthier. The FDA needs to reevaluate the safety of many additives that have long been thought to be safe based on outdated data or limited data. It also needs to start regulating environmental contaminants from food processing and packaging that can be harmful to human health,” she says.

Based on outcomes from nearly 130,000 adults, the results contribute to mounting research suggesting that red meat, which is high in saturated fat, can be bad for the brain.

“Our findings provide further evidence that higher red meat consumption, especially processed red meat consumption, is associated with higher risk of cognitive decline and dementia risk,” says Yuhan Li, PhD, an assistant professor of anesthesia at Brigham and Women’s, a teaching hospital affiliated with Harvard Medical School in Boston.

“Additionally, our results highlight the benefits of replacing processed red meat with healthier alternatives, such as nuts and legumes, contributing to the development of actionable diet guidance for improving dietary patterns to support cognitive health.”

Higher Red Meat Consumption Tied to Greater Dementia Risk

To measure the risk of dementia from eating red meat, Dr. Li and his team followed about 134,000 individuals for up to 43 years. Participants were an average age of 49 and did not have dementia when the research began. They completed a food diary every two to four years, listing what they ate and how often. By the end of the study, 11,173 (8.3 percent) had developed dementia.

Processed red meats were defined as products such as bacon, hot dogs, sausages, salami, and bologna, while unprocessed red meats were defined as beef, pork, lamb, and hamburger. A serving was considered to be 3 ounces — about the size of a pack of cards.

For the analysis of processed meat, participants were separated into three groups. On average, the low-consumption group ate less than one-tenth of a serving per day (or about three servings per month), the medium group ate one-tenth to less than one-quarter serving per day, and the high group ate one-quarter serving or more per day (or about two servings at least per week).

The findings showed that those who were eating the most processed meat had 13 percent greater odds of developing dementia compared with those in the low consumption group.

To evaluate dementia risk in relation to unprocessed red meat, researchers compared individuals who ate an average of less than one-half serving per day with those who ate one or more servings per day. They did not find a difference in dementia risk.

Evaluating Cognitive Decline

To gauge cognitive decline, scientists analyzed subjective measures based on surveys in which participants rated their own memory and thinking skills twice during the study. They also weighed objective measures based on memory, thinking, and problem-solving tests given four times during the study.

In the subjective group, which included about 44,000 participants who were an average age of 78, those who ate an average of at least one-quarter serving of processed red meat per day had a 14 percent higher risk of cognitive decline compared with those who ate less than one-tenth of a serving.

Researchers also highlighted that those who ate one or more servings of unprocessed red meat per day had a 16 percent higher risk of subjective cognitive decline compared with those who ate less than one-half of a serving per day.

From the objective group analysis, which looked at about 17,000 female participants with an average age of 74, study authors found that eating more processed red meat was associated with faster brain aging, with the brain being 1.61 years “older” with each additional serving per day.

Why Is Processed Meat Bad for the Brain? 

The high saturated fat content in red meats — whether processed or unprocessed — may be a primary contributor to mental decline, according to Li.

For Yuko Hara, PhD, director of aging and Alzheimer’s prevention at the Alzheimer’s Drug Discovery Foundation, the difference between processed and unprocessed red meats may be due to ingredients added to processed products.

Heather Snyder, PhD, the senior vice president of medical and scientific relations at the Alzheimer’s Association, confirms that it’s the ultraprocessing that may be especially bad for the brain.

Swapping Red Meat for Healthier Alternatives

The study authors also looked at the data to see how people might lower risk, and they found that replacing one serving per day of processed red meat with one serving per day of nuts and beans was associated with a 19 percent lower risk of dementia and 1.37 fewer years of cognitive aging.

Making the same substitution for fish was linked to a 28 percent lower risk of dementia, and replacing it with chicken was linked with a 16 percent lower risk of dementia.

Rebecca Beaudoin, RDN, a nutrition therapist with Nebraska Medicine in Omaha, especially stresses the value of eating more plants in your diet.

“We know that increasing the consumption of plants is associated with greater health,” says Beaudoin. “As we increase our consumption of fruits, veggies, beans, and whole grains, we increase both our fiber, which is anti-inflammatory, and phytochemicals, natural substances that can help protect against cell damage.”

It’s helpful for explaining why, for example, when someone’s favorite weather person delivers the morning forecast, that viewer’s attitude is: “I trust this weatherman and what this weatherman is saying must be true,” says Rachel Kowert, PhD, an Ottawa, Canada–based research psychologist and the research director of Take This, a mental health advocacy organization with a focus on the digital gaming industry. “The viewer or the fan feels like they really know, relate, and have a sense of familiarity to the person they’re following.”

These days, parasocial relationships may seem especially intimate since it’s simple for famous people to engage with their followers on social media, but not necessarily in the deep, meaningful ways that we connect with our real-life friends and family.

“What’s unique is that it’s reciprocal now and that makes the lines even blurrier,” Dr. Kowert says.

“Increased exposure to real-life friends through screen media may blur the lines between the social and parasocial, increasing the value of parasocial relationships during social distancing,” the researchers of that study concluded.

1. Obstructive Sleep Apnea

“Severe sleep apnea can cause irregular heart rate, lack of oxygen to the brain, and even death [if untreated for a long time],” says Mangala Nadkarni, MD, the medical director of the center for sleep disorders at RWJ Barnabas Health in Livingston, New Jersey. Symptoms someone might notice earlier on after developing sleep apnea are excessive daytime sleepiness and fatigue, because the blocked breathing during sleep prevents someone from getting to the deep, more restorative stages of sleep. Long term, sleep apnea increases the risk of hypertension, heart failure, and stroke.

What can you do if you’re experiencing secondary traumatic stress from the news? While it’s important to be informed about what’s happening in the world, it’s also crucial to prioritize your well-being.

Here’s how experts say you can do both:

1. Limit Your Social Media Use

Gone are the days of keeping up with the news solely through newspapers and TV reports, consumed at specific times of the day. Today, many of us are consuming information (and news) via social media frequently over the course of a day. And this type of continuous use can be overwhelming if it’s flooding us with nonstop traumatic headlines.

Sometimes social media posts offer more graphic news material or raw detail than you might read in a news article — or that you might need to stay informed, explains Lawson. Traditional media outlets may be more likely to deliver news in a more sensitive way that’s potentially less triggering to viewers, he says.

2. Take Frequent Breaks From Watching or Reading the News

It may also help to take breaks and turn off the news when following coverage of traumatic events, adds Lawson.

“I think it is important to set and keep to a limit on how much time you will spend consuming this news, like 10 to 20 minutes,” Lawson advises. “It is easy to follow one story into the next, and soon you have spent hours immersed in the traumatic material, which can contribute to the vicarious [or secondary] trauma.”

Peifer agrees, adding that while research has traditionally focused on those who’ve directly experienced or witnessed traumatic events, people are increasingly reporting trauma responses just from seeing or hearing the news, due to greater access to traumatic material 24/7 across news, social media, and other platforms.

“For example, with the news coverage around the Uvalde school shooting, clients have noted changes in hypervigilance, rumination, worry about sending their child to school, nightmares, and many symptoms,” Peifer explains.

3. Tune In to How Your Mind and Body Feel During a Newscast

Be sure to pay attention to any thoughts and physical sensations you’re having — such as sweating or a rapid heartbeat, for instance — during a continuous news cycle, says Lawson.

If you’re experiencing intense anxiety and sadness or feeling overwhelmed, it may signal that it’s time for you to take a break and take care of yourself, whether it be through talking to a loved one about what you’re feeling, listening to calming music, or going for a nature walk. Any activity that brings you joy and helps you feel well enough to go about your daily life counts as self-care.

Follow the “Put on your own oxygen mask before helping others” philosophy, says Lawson. “The same concept applies here,” she says. If you’re experiencing debilitating secondary trauma due to news coverage, it’s going to be challenging to properly take care of yourself or others around you.

4. Channel Your Emotion Into Action

If you feel up to it, Lawson adds, you could channel your anger, sadness, or any other emotion you’re feeling into action for change, such as writing to your senators and representatives in Congress about your support for legislation to help prevent certain traumatic events such as gun violence or hate crimes from repeating.

5. Seek Professional Help if You Need It

• Appetite changes
• Energy or activity level changes
• Experiencing headaches, stomach aches, body pains, and skin rashes
• Feeling angry, sad, fearful, worried, frustrated, or numb
• Having trouble concentrating and making decisions
• Having trouble sleeping or nightmares
• Increasing your use of tobacco, alcohol, or other drugs
• Worsening of chronic health issues

Here are a few of the benefits of following a low-cholesterol diet.

May Help Lower LDL Cholesterol

May Help Lower Blood Pressure

May Improve Brain Health

May Boost Mood

May Improve Digestive Health

Sleep is also essential for hormone regulation, and insulin is a hormone. “In general, poor sleep plays a role in insulin resistance,” says Bidwell, which occurs when your body has difficulty using insulin to move glucose from your blood into cells. This can result in high blood sugar. “If you are struggling to gain control of your blood glucose, looking at your sleep and doing what you can to get the recommended seven-plus hours can be a game changer,” Bidwell says.

While it’s not clearly understood why sleeping longer may be detrimental to your health, there are many potential hormonal changes that occur with sleep loss. “There is a biochemical cascade driven by inflammatory substances, such as cytokines, after sleep loss that can set someone up for insulin resistance,” notes Bidwell. What’s more, as the aforementioned research points out, sleep deprivation activates your sympathetic nervous system, responsible for your fight-or-flight stress response, which can also decrease insulin sensitivity. This is an area of ongoing research.

Early detection is key when treating frostbite, says Robert Glatter, MD, an assistant professor of emergency medicine at Northwell Lenox Hill Hospital in New York City. Without proper medical care, frostbite can contribute to complications like sensitivity to cold, long-term numbness, joint stiffness, gangrene, and hypothermia, per Mayo Clinic. Seek medical attention if you experience signs of severe frostbite. These include white or blue-gray skin, loss of sensation or an inability to feel cold, joint and muscle malfunction, blisters that appear 24 to 48 hours after rewarming, or tissue that has turned black and hard.

How Do You Know When You’re at Risk for Hypothermia?

Hypothermia happens when your body loses heat faster than it can produce it, and your body temperature drops dangerously low (below 95 degrees F), according to Mayo Clinic. This drop in body temperature prevents your heart, nervous system, and other organs from working normally.

“Hypothermia is a medical emergency,” says Dr. Glatter. “As your body temperature drops, your heart, brain, and internal organs cannot function. Without aggressive resuscitation and rapid rewarming, you will ultimately not survive.” Glatter notes that one of the first signs of hypothermia is shivering (as your body tries to produce heat), followed by slower breathing and heart rate in the second stage, along with confusion and sleepiness.

“The insidious thing about hypothermia is that it often causes impaired cognition, which affects the ability to recognize what’s wrong, so the hypothermia can get worse,” says Bradley J. Uren, MD, clinical associate professor of emergency medicine at the University of Michigan Medical School in Ann Arbor; Penn Medicine also describes this phenomenon. Dr. Uren and Glatter both note that the impairment can make someone look intoxicated, stumble, and speak incoherently — hypothermia mimics a stroke in this way — but checking your temperature can give some insight into where these symptoms are coming from.

If you’re sweating or wet for another reason your risk of hypothermia increases. (Remember: Snow melts, especially when it gets under your coat and onto your skin.) So if you’re a die-hard runner and have to get your miles in or plan to be outside and active in the snow, take precautions to stay dry. When the temperature drops, wear a synthetic base layer to wick away moisture, according to the Cleveland Clinic. The Cleveland Clinic then advises you to layer up; you can take these extra layers off and tie them around your waist as you start getting hot on your run.

“That’s your ideal way to protect yourself against not only the outside elements, but to help protect you from sweat that could inadvertently contribute to hypothermia,” says Uren. “Water, in any form, is the greatest enemy.”

Even if you’re planning to stay dry, being outside during extremely cold temps in inappropriate clothing can put you at risk for hypothermia.

What to Wear if You Have to Be Outside in the Extreme Cold

If you have to be outside, make sure you dress for it (and plan ahead so you can avoid being outside for too long). Regardless of the activity you’re doing outdoors (be it shoveling snow, walking your dog, or commuting to work), layering will keep your whole body warm in this kind of weather. “Go for looser rather than tighter layers, because it keeps a layer of air between the cloth. That air will stay warm and take longer to cool, as opposed to the cloth itself, which can cool down from outside temperatures,” Ford and the American Academy of Dermatology (AAD) note. In cold, wet weather, wear wool instead of cotton, because wool repels moisture and helps you maintain dry, warm air in your clothing layers, the AAD adds.

To protect your lungs, use a scarf or a ski mask (or even a pulled-up sweater to cover your mouth and nose), suggests Mayo Clinic Health System. Just as you do when layering clothes, keep a buffer zone between your face and the fabric to give the air a place to warm up before it hits your lungs, Ford says.

Don’t forget to wear a hat and gloves or mittens, either. Cleveland Clinic advises that, contrary to popular belief, you don’t lose any more heat from your head than from other body parts, but the head does have a large surface area of skin. A hat helps because you’re covering up more of that exposed skin. If he has to work outside, Ford wears a pair of thin gloves and then outer gloves, and slips hand warmers between the inner and outer gloves; the thin gloves protect his hands from potential damage from the hand warmers.

One area vulnerable to frostbite that many people tend to neglect is the skin around their eyes. Uren suggests wearing ski goggles to protect against the wind and retain heat if you must be outside in extreme cold.

Keep in mind that the air is very, very dry when it’s super cold, and will draw moisture from your body, causing you to lose fluids quickly. If you’re breathing hard while outside, be sure to keep water handy in a stainless steel, vacuum-sealed thermos to avoid dehydration.

Uren also keeps a shovel, emergency kit, zero-degree sleeping bag, and boots in his trunk during the winter in case of unplanned, emergency exposure to the elements.

How to Successfully Manage Chronic Disease in Extremely Cold Weather

If you’re healthy and have your skin and airways fully covered, you likely will be fine outside for 10-minute stints when the windchill is at or slightly below 0 degrees F, Uren says. But if you’re managing a disease, you may need to be extra cautious in extremely cold temperatures. Here’s why.

Asthma For anyone, inhaling extremely cold air exposes moist lung tissue to the cold and can cause airways to tighten and feel constricted. If you have asthma, you’re at risk of immediately feeling short of breath, wheezing, and coughing, according to Harvard Health Publishing. If you’ve been instructed to use a rescue inhaler, that can help. “But if you have difficulty breathing, you shouldn’t wait. Go to the nearest emergency department,” Uren says.

Diabetes Because of the body’s changes in blood circulation in the cold, blood sugar levels in folks with diabetes can be erratic, mostly in type 1 diabetes, but it’s also possible in type 2 diabetes, Ford says. If you’re feeling dizzy or weak when you come back inside, check your blood sugar. If you’re using insulin and you keep it in the car, bring it inside so the medication doesn’t freeze, per the CDC.

If you have diabetic neuropathy, or nerve damage, be aware that you may not be able to feel when your feet are getting too cold and you are at risk for frostbite, according to the University of Rochester Medical Center.

Arthritis Arthritis may act up in very cold weather. “I’m not aware if anybody has found a medical basis for it, but I see people having more joint pain,” Uren says. If you have to shovel snow, Ford suggests taking some anti-inflammatory drugs first and breaking the work into 10-minute shifts. Once you’ve warmed up inside and have feeling back in your hands, it’s safe to go out. If you know the cold is a trigger for your joint pain, talk to your doctor to have an action plan.

Autoimmune disease Raynaud’s phenomenon is a condition affecting blood flow that results in your fingers and toes undergoing extreme changes even in normal cold weather; your extremities may turn very white, then turn blue or red when they warm up. The causes aren’t well understood, Ford says, but it puts patients at greater risk for frostbite. Raynaud’s can occur on its own or in association with a variety of autoimmune diseases, particularly lupus, and less frequently with rheumatoid arthritis, past research shows. With Raynaud’s, it’s often painful to go out in cold weather, so you should limit your time outside and wear extra gloves and use hand warmers if you do go out.

Cancer If you’re in an immunosuppressed state, as those with cancer are, you’re more at risk for complications from communicable diseases like the cold and flu during the winter. In addition, those undergoing active cancer treatment may be more sensitive to harm from cold exposure because of anemia and dehydration, which can compromise their ability to maintain a healthy temperature, and they also may have neuropathy from chemotherapy, which increases the susceptibility to frostbite, according to Northwestern Medicine. It’s best to talk to your oncologist to discuss your specific cold weather risks if you have cancer.

Chronic obstructive pulmonary disease (COPD) Because every case of COPD is different, it’s important to pay attention to what your body is telling you. “Most people I take care of understand, ‘If I go outside and it’s colder than x degrees, I’m going to have a problem.’ Some have found that wrapping a scarf [around their mouth and nose] to breathe warm air helps, but that doesn’t work for everyone,” Uren says. If your COPD is poorly managed, plan ahead to stay inside and work with friends and family to make sure you have everything you need.

Heart disease Cold temperatures can add strain to your cardiovascular system, making your heart work harder, which can put you at greater risk of heart attack, according to Northwestern Medicine. If you’re managing heart disease, be careful about doing strenuous activity. For example, instead of shoveling snow, consider hiring your neighbor’s kid or a service to do it. “The combination of very cold weather and a lot of heavy snow can put a strain on anybody,” Uren says.

Inflammatory bowel disease (IBD) Ford says it’s hard to predict how the cold can affect IBD. “Most of the inflammation is in the intestines, and that’s part of the core that would be the last part to feel the effects of the cold weather,” he says. “It’s certainly possible that prolonged exposure could make the situation worse, but it would be unlikely to happen from a brisk walk outside.”

Long COVID People with long COVID need to take extra caution in the cold temperatures and snow, says Glatter. According to a review, lung function and capacity may be reduced for some time after a COVID-19 infection, leading to a higher risk of infection and disease, so Glatter advises those with long COVID to remain at home when temperatures are low to avoid the risk of secondary pneumonia, influenza, and other respiratory viruses. “At the very least, we must advise extra precautions in patients with long COVID; they should make sure to wear a well-fitted N95, KN95, or KF94 mask, particularly in all indoor settings with other people, and in those with poor ventilation,” says Glatter.

Mental health condition “For people with seasonal affective disorder, bipolar disorder, or depression, having to stay inside for long periods of time can be problematic,” says Pedro L. Dago, MD, an assistant professor of psychiatry and behavioral sciences at the Northwestern University Feinberg School of Medicine in Chicago. To manage symptoms, he recommends maintaining a sleep schedule and exercise regimen, and getting as much sunlight as possible. If it’s not possible to go outside, he suggests opening curtains and blinds to let light into your home (and Johns Hopkins Medicine suggests sitting near a window). Be sure to apply sunscreen before exposure to the sun, and choose a product with an appropriate SPF based on the intensity of the sun where you are — yes, even if you’re inside. And don’t let the cold temperatures prevent you from seeking help if you need immediate attention, Dr. Dago says: “There tends to be a decrease in the number of people we see in the emergency department when it gets extremely cold outside, but no one should wait to get the care they need.” Take the precautions already mentioned if you need to venture out, but don’t delay care.

Multiple sclerosis (MS) People with MS may need to take more precautions to maintain mobility in the cold weather than in warmer weather. The cold can exacerbate pain or weakness, per the Multiple Sclerosis Foundation, but the highest risk is loss balance and slips and falls on ice. “You just have to be careful,” Ford says.

Skin conditions Cold, dry winter weather may exacerbate symptoms of eczema and psoriasis, according to Cleveland Clinic and the National Psoriasis Foundation. It’d be a delayed response — you wouldn’t see the effects within minutes of being in the cold — and it should stop as soon as you get into a warm environment. To avoid this, be sure to keep your skin moisturized while you’re indoors. Ford suggests following your normal treatment or medication plan and covering up when you go outside.

Why Preparation Is Key for Surviving the Extreme Cold

One thing to keep in mind: If you’ve lived in an area that has historically had extremely cold temperatures, your body may respond differently to the weather than someone who is from a warmer region. “A lot has to do with what you’re used to and have adapted to,” Ford says. “The body is pretty resilient and has a lot of defense mechanisms.”

Still, manageable steps like dressing in appropriate layers, taking indoor breaks when you’re working outside, and remembering to take it slow on icy roads and sidewalks will help you avoid the pitfalls of winter weather.

“As ER doctors, we’re trying to put ourselves out of business,” Uren says. “We see the bad outcomes associated with extreme weather and so many could be really easily prevented.”

Over-the-Counter (OTC) Pain Relievers

Triptans

• eletriptan (Relpax)
• rizatriptan (Maxalt)
• zolmitriptan (Zomig)
• frovatriptan (Frova)
• naratriptan (Amerge)
• sumatriptan (Imitrex)
• almotriptan

According to Everyday Health network site Migriane Again, triptans come in many forms, including oral pills, nasal sprays, nasal powder, and injections. Non-oral methods (e.g., nasal sprays and injections) can be more effective for people experiencing the migraine symptom of nausea or vomiting as the digestive system tends to slow during an attack.

Ergots

Gepants

• atogepant (Qulipta)
• rimegepant (Nurtec ODT)
• ubrogepant (Ubrelvy)
• zavegepant (Zavzpret)

5-HT1F Receptor Agonists (Ditans)

Antiemetics

• chlorpromazine
• prochlorperazine (Compro)
• metoclopramide (Reglan)
• droperidol (Inapsine)

Antihypertensive Medications

• propranolol (Inderal LA or Innopran XL)
• metoprolol tartrate (Lopressor)
• timolol (Betimol)

Antidepressants

Antiseizure Drugs

The exact way in which these medications prevent migraine attacks is unclear. You would take them as a daily or twice-daily dose.

Botox

CGRP Monoclonal Antibodies

CGRP antibody drugs include:

• eptinezumab (Vyepti)
• erenumab (Aimovig)
• fremanezumab (Ajovy)
• galcanezumab (Emgality)

Corticosteroids, or Steroids

Nerve Blocks for Acute Migraine Pain Relief

Emergency Medication for Intractable Migraine

Those drugs may include:

• Antiepileptics
• Triptans
• NSAIDs
• Steroids
• Muscle relaxants
• Antipsychotic medications

Ideally, your emergency migraine treatment plan should include:

• Your diagnosis
• Any relevant information about your medical history
• Your doctor’s recommendations for the safest and most effective medications for you
• Your doctor’s signature and contact information