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偏頭痛の女性
偏頭痛の女性

予防薬を中心とする偏頭痛の発作予防の様々な方法

偏頭痛の女性

偏頭痛に対して効果的な予防をするためには薬物療法が中心となります。偏頭痛は発作が起きてからその痛みを解消することもとても重要ですが、それと同時に偏頭痛の苦しみを味わなくても良いように、予防薬を効率的に活用することが大切となります。

では偏頭痛の予防薬としてはどのような種類のものがあり、また、薬物療法はどのようなプロセスを経て行われていくのでしょうか。本稿では予防薬を中心とした偏頭痛の予防法についてまとめています。

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偏頭痛の症状と痛み発生の原理

偏頭痛おじさん

偏頭痛は、頭の側面(両方あるいは一方)がたいへん痛むタイプの頭痛です。偏頭痛を患っておられる方は、日本でおよそ800万人いると言われます。東京都の人口で言えば約半分以上(東京都の人口は約1300万人)にあたる人数で大変多いということができるでしょう。

どうして偏頭痛が発症するのか(偏頭痛持ちの方とそうでない方とがどうしているのか)という点に関しては、原因は不明です。しかし、偏頭痛の痛みが発症するメカニズムについてはある程度解明されています。

つまり、偏頭痛の発作が起きるときには、血液中のセロトニンという物質が増加して、脳の血管が拡張してしまい神経を圧迫してしまうため、偏頭痛の独特の痛みが発生するという考え方(血管説という考え方)が偏頭痛の痛みが発生するメカニズムとして有力です。

偏頭痛の発作を予防するための薬物もこのような観点から作られています。
偏頭痛を予防する薬としては以下のようなタイプの薬があります。

カルシウム拮抗薬

偏頭痛の発作を予防するために利用される薬剤としてカルシウム拮抗薬というタイプの薬剤があります。カルシウム拮抗薬は筋肉にカルシウムイオンが入ることを遮断し、血流を良いものとして偏頭痛の発作が生じることを予防します。

例えば、カルシウム拮抗薬の中でも塩酸ロメリジンという名前の薬剤は日本で開発され、保険適用も認められている安全な薬剤です。カルシウム拮抗薬は次に述べます、β遮断薬などとともに偏頭痛の予防に非常に多く用いられています。

β遮断薬

β遮断薬は本来、心臓の働きを抑制して血圧を下げるという循環器系の疾患に利用され他薬剤です。しかし、β遮断薬は偏頭痛の予防にも効果があるとして、幾度もの実験が続けられました。その結果、β遮断薬は偏頭痛の予防としての「効果は確実」と言われる薬剤です。(日本頭痛学会ホームページより)ただ、β遮断薬を偏頭痛の予防のために利用する場合には保険の適用はないことになります。

偏頭痛予防薬の利用法

偏頭痛の予防薬を用いる場合には、予防効果があることや副作用がないことなどを確認しながらじっくりとその効果を確かめていくことになります。

偏頭痛予防薬を利用する場合、予防効果が出るかどうかまで約2ヶ月程度の期間、薬を投与するのが一般です。その後、半年程度薬物を利用した偏頭痛の予防を行い、ご自身で偏頭痛をコントロールすることができるようになった頃を見計らい、
使用を終了することになります。

偏頭痛の予防はこのように薬物を利用することが効果的ですが、同時に薬物以外でも予防効果が出るように生活上配慮をすることが必要となってきます。偏頭痛を予防するための薬物以外の方法としては以下のような点が重要となってきます。

偏頭痛を予防する生活上のポイント

偏頭痛は生活上のストレスや身体的な疲労などが引き金となり、発症します。例えば、睡眠不足や疲労・精神的ストレス・長時間同じ姿勢でいること(筋肉が疲労します)お酒の飲みすぎなどが偏頭痛の発作が生じる原因となります。また寝過ぎ・過眠も偏頭痛にはよくありません。

このように偏頭痛を予防するためには、日頃の生活をご自身でコントロールされることが非常に重要となります。お酒の席などでは、偏頭痛発作のためにあまり飲み過ぎることができないことなどを周りの人に理解してもらうことがとても重要となります。

同時に周囲に偏頭痛持ちの方がおられる場合には配慮してあげることも重要と言えるでしょう。偏頭痛の予防を効果的にするためには、予防薬を利用しつつ、生活にも配慮することがとても大切となってきます。

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まとめ:予防薬を中心とした偏頭痛予防のまとめ

以上、本文で述べました予防薬の利用を中心とした偏頭痛予防のポイントをまとめますと以下のようになります。

  • 偏頭痛予防薬の種類-カルシウム拮抗薬・β遮断薬など。偏頭痛予防のためにこれらを利用する場合、カルシウム拮抗薬は保険適用の対象となりますが、β遮断薬は保険適用の対象となりません
  • 偏頭痛予防薬の服用等-偏頭痛予防薬は2ヶ月程度投薬が行われ、効果や副作用の有無等を慎重にチェックします。予防の効果があらわれて、ご自身でも偏頭痛をコントロールすることができるようになった場合、概ね半年程度をめどに予防薬の利用を終了することになります
  • 偏頭痛を予防するためには生活習慣を見直すことも重要です。具体的には、   睡眠不足・過眠・疲労・精神的ストレス・長時間の同じ姿勢・お酒の飲みすぎなど二気をつけることが大切です。

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