Migraines and TreatmentsOur patient, Ms. Blum, is a 28-year-old white woman who experiences symptoms of migraine, such as waking up with a severe headache that she says, is often aggravated. when she turns on the light. Additionally, Ms. Blum exhibits several factors that may trigger her migraines, including her lack of sleep, her stressful life, as concluded by her statement that this has been a difficult time in her life and the approaching deadline to remit. her thesis, her weekend drinking, her menstrual cycle since she notices that a few days before her period starts she feels these headaches, she also states that food does not seem to attract her and that it takes effort for him to eat a meal, and his diagnosis of major depressive disorder. Migraines, three times more prevalent in women than in men, are characterized by frequent attacks of painful, moderate to severe headaches, often associated with nausea, vomiting and sensitivity to sound and light. This headache usually occurs on one side of the head and is described as a throbbing, stabbing, or throbbing pain lasting 4 to 72 hours if left untreated. Migraines may also present with or without aura (a sensory warning symptom).1 Lack of sleep and food, alcohol consumption (especially wine), tobacco smoke, bright lights, strong smells, loud noises, specific foods, certain medications (vasodilators), emotional disorders. or physical stress, anxiety, environmental changes, and hormonal fluctuations during the menstrual cycle can trigger a migraine.2 Additionally, Ms. Blum has been diagnosed with depression, which has been associated with migraines. Studies have shown that patients with migraines are at increased risk of developing...... middle of article ......11–221.4. Henderson, L., Yue, Q.Y., Bergquist, C., Gerden, B., and Arlett, P. (2002). St. John's wort (Hypericum perforatum): drug interactions and clinical results. British Journal of Clinical Pharmacology. 2002; 54(4):349-356.5. Ashkenazi A, Silberstein S. Menstrual migraine: a review of hormonal causes, prophylaxis and treatment. Pharmacother expert opinion. Aug 2007;8(11):1605-13.6. Aycock DG. Ibuprofen: a monograph. Am. Pharm., Nova Scotia, 1991; 31(1):46-49.7. Davies NM, Reynolds JK, Undeberg MR, Gates BJ, Ohgami Y, Vega-Villa KR. Minimize the risks of NSAIDs: cardiovascular, gastrointestinal and renal. Expert Reverend Neurother. 2006 Nov;6(11):1643-55.8. Dowson AJ, Charlesworth B. Review of zolmitriptan and its clinical applications in migraine. Pharmacother expert opinion. July 2002;3(7):993-1005.9. Loder E. Triptan therapy in migraine. N Engl J Med. July 2010 1;363(1): 63-70.