By Christie Aschwanden

Migraine headaches slammed into Evelyn Strauss’s life during her sophomore year in college. “I would have to retreat to a dark room for two or three days every time I got one, which was every few weeks,�?says the 41-year-old editor in Santa Cruz, California. “It was horrible. I had to schedule my studying around my migraines.�?She tried several medications, but nothing worked. With nothing to lose, she decided to see a hypnotist. “Hypnosis got rid of the headaches completely,�?she says.

Strauss’s story would not surprise Donald Penzien, a psychologist at the University of Mississippi Medical Center in Jackson. While most people quiet their headaches by popping over-the-counter pain medications or prescription headache drugs, these pills don’t work for everyone, he says. And frequent use of them can actually make the problem worse by triggering rebound headaches—pain that begins as soon as the medication wears off, requiring still more medication and perpetuating the cycle.

Penzien is convinced there’s a better way. He recently published a study analyzing the last 30 years of research into often-overlooked behavioral treatments for headaches, including mind-body therapies like biofeedback and hypnosis. His conclusion: These treatments may actually manage headaches better than drugs. In fact, the real trick to taming headaches is to keep them from developing in the first place—which these mind-body techniques and other alternative remedies can help you do. If a headache does slip through, some of the same treatments can curb symptoms, too.

Whichever therapies you choose, the key is to use them regularly—singly or in combination—as part of a strategy to stop headaches before they start. “Prevention is the name of the game,�?Penzien says.

Identify your triggers
Experts classify headaches into dozens of different types, but tension headaches and migraines are by far the most common, and some people battle both types. No one’s 100 percent sure what causes headaches, but for most people, they’re set off by one or more triggers, which can differ from person to person.

That’s why the first step in a preventive strategy is recognizing what your triggers are and finding ways to avoid them. Common culprits include stress, disrupted sleep patterns, bright light, noise, alcohol, caffeine, and certain foods like cheese and chocolate. (It can be helpful to keep a headache diary, noting when the pain comes on and what you ate, drank, and did beforehand.)

When journalist Lila Guterman, 29, moved to London in 1998, she noticed that her previously infrequent migraines suddenly became regular. “They were often totally incapacitating,�?she says. Thinking about what had changed since her move, she realized that she was making more trips to the coffeepot at her new job. So she quit cold turkey. The first week sans caffeine she felt a mild headache or two, but then they disappeared entirely. “I didn’t get another headache the whole time I was in London,�?she says. Guterman hasn’t gone back to coffee and she rarely gets migraines these days.

Try triple therapy
For Alexander Mauskop, a three-pronged approach is definitely the ticket. A neurologist who directs the New York Headache Center and is coauthor of What Your Doctor May Not Tell You About Migraines, he advises his patients to take a supplement combo he calls triple therapy. It’s a mix of magnesium, riboflavin (also called vitamin B2), and feverfew (Tanacetum parthenium). “All three have been proven effective in double-blind studies and have no serious side effects,�?he says.

Mauskop has published more than ten studies showing a link between magnesium and head pain, and he believes magnesium deficiency plays a role in many, but not all, headaches.

A 1998 study compared a dose of 400 milligrams of riboflavin against a placebo in 55 people with migraines. Over the course of three months, people in the riboflavin group had significantly fewer headaches than those who popped placebos. And a double-blind, placebo-controlled study published in 1988 showed that migraine sufferers who took feverfew had fewer and less severe headaches.

Given this evidence, Mauskop recommends a daily dose of 300 to 500 mg of magnesium (look for the magnesium oxide or chelated magnesium forms), 400 mg of riboflavin, and 100 mg of feverfew for headache prevention.

Before Alice Miceli, a housewife in Bayside, New York, made a visit to Mauskop’s clinic, she says, “I didn’t have a life—every migraine I got lasted 15 hours. Holidays were ruined. I couldn’t make any plans with friends.�?Then she gave his regimen a try.

“It took about three months for the supplements to really kick in, and then it was amazing,�?she says. “I went from 20 headaches per month to maybe two. When I do get them it’s not debilitating like it was before. I can take vacations again. This therapy gave me my life back.�?/FONT>