Migraine treatments can help stop symptoms and prevent future attacks.Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:
- Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
- Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.
Some medications aren’t recommended if you’re pregnant or breast-feeding. Some medications aren’t given to children. Your doctor can help find the right medication for you.
Take pain-relieving drugs as soon as you experience signs or symptoms of a migraine for the best results. It may help if you rest or sleep in a dark room after taking them. Medications include:
- Pain relievers. Aspirin or ibuprofen (Advil, Motrin IB, others) may help relieve mild migraines.Acetaminophen (Tylenol, others), also may help relieve mild migraines in some people.Drugs marketed specifically for migraines, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraine pain. They aren’t effective alone for severe migraines.
If taken too often or for long periods of time, these medications can lead to ulcers, gastrointestinal bleeding and medication-overuse headaches.
The prescription pain reliever indomethacin may help thwart a migraine and is available in suppository form, which may be helpful if you’re nauseated.
- Triptans. These medications are often used in treating migraines. Triptans make blood vessels constrict and block pain pathways in the brain.Triptans effectively relieve the pain and other symptoms that are associated with migraines. They are available in pill, nasal spray and injection form.Triptan medications include sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax).
Side effects of triptans include reactions at the injection site, nausea, dizziness, drowsiness and muscle weakness. They aren’t recommended for people at risk of strokes and heart attacks.
A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own.
- Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 48 hours. Ergots are most effective when taken soon after migraine symptoms start.Ergotamine may worsen nausea and vomiting related to your migraines, and it may also lead to medication-overuse headaches.Dihydroergotamine (D.H.E. 45, Migranal) is an ergot derivative that is more effective and has fewer side effects than ergotamine. It’s also less likely to lead to medication-overuse headaches. It’s available as a nasal spray and in injection form.
- Anti-nausea medications. Medication for nausea is usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro).
- Opioid medications. Opioid medications containing narcotics, particularly codeine, are sometimes used to treat migraine pain for people who can’t take triptans or ergots. Narcotics are habit-forming and are usually used only if no other treatments provide relief.
- Glucocorticoids (prednisone, dexamethasone). A glucocorticoid may be used with other medications to improve pain relief. Glucocorticoids shouldn’t be used frequently to avoid side effects.