Migraine Headache Treatments
Migraine has no cure. But your migraines can be managed with your doctor’s help. Together, you will find ways to treat migraine symptoms when they happen, as well as ways to help make your migraines less frequent and severe. Your treatment plan may include some or all of these methods.
Medicine. There are two ways to approach the treatment of migraines with drugs: stopping a migraine in progress (called “abortive” or “acute” treatment) and prevention. Many people with migraine use both forms of treatment.
Acute treatment. Over-the-counter pain-relief drugs such as aspirin, acetaminophen, or NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen relieve mild migraine pain for some people. If these drugs don’t work for you, your doctor might want you to try a prescription drug. Two classes of drugs that doctors often try first are:
Triptans, which work by balancing the chemicals in the brain. Examples include sumatriptan (Imitrex®), rizatriptan (Maxalt®), zolmitriptan (Zomig®), almotriptan (Axert®), eletriptan (Relpax®), naratriptan (Amerge®), and frovatriptan (Frova®). Triptans can come as tablets that you swallow, tablets that dissolve on your tongue, nasal sprays, and as a shot. They should not be used if you have heart disease or high blood pressure. Ergot derivatives (ergotamine tartrate and dihydoergotamine), which work in the same way as triptans. They should not be used if you have heart disease or high blood pressure.
Most acute drugs for migraine work best when taken right away, when migraine symptoms first begin. Always carry your migraine medicine in case of an attack. For people with extreme migraine pain, a powerful “rescue” drug might be prescribed, too. Because not everyone responds the same way to migraine drugs, you'll need to work with your doctor to find the treatment that works best.
Prevention. Some medicines used daily can help prevent migraine attacks. Many of these drugs were designed to treat other health conditions, such as epilepsy and depression. Some examples are:
antidepressants, such as amitriptyline (Elavil®) or venlafaxine (Effexor®)
anti convulsants, such as divalproex sodium (Depakote®) or topiramate (Topamax®)
beta-blockers, such as propranolol (Inderal®) or timolol (Blocadren®)
calcium channel blockers, such as verapamil
These drugs may not prevent all migraines, but they can help a lot. Hormone therapy may help prevent attacks in women whose migraines seem to be linked to their menstrual cycle. Ask your doctor about prevention drugs if:
your migraines do not respond to drugs for symptom relief
your migraines are disabling or cause you to miss work, family activities, or social events
you are using pain-relief drugs more than two times a week
Lifestyle changes. Practicing these habits can reduce the number of migraine attacks:
Avoid or limit triggers.
Get up and go to bed the same time every day.
Eat healthy foods and do not skip meals.
Engage in regular physical activity.
Limit alcohol and caffeine intake.
Learn ways to reduce and cope with stress.
Alternative methods. Biofeedback has been shown to help some people with migraine. It involves learning how to monitor and control your body’s responses to stress, such as lowering heart rate and easing muscle tension. Other methods, such as acupuncture and relaxation, may help relieve stress. Counseling also can help if you think your migraines may be related to depression or anxiety. Talk with your doctor about these treatment methods.
What are rebound Migraines?
Women who use acute pain-relief medicine more than two or three times a week or more than 10 days out of the month can set off a cycle called rebound. As each dose of medicine wears off, the pain comes back, leading the patient to take even more. This overuse causes your medicine to stop helping your pain and actually start causing headaches. Rebound headaches can occur with both over-the-counter and prescription pain-relief medicines. They can also occur whether you take them for headache or for another type of pain. Talk to your doctor if you're caught in a rebound cycle.
I'm pregnant. Can my Migraines still be treated?
Some migraine medicines should not be used when you are pregnant because they can cause birth defects and other problems. This includes over-the-counter medicines, such as aspirin and ibuprofen. Talk with your doctor if migraine is a problem while you are pregnant or if you are planning to become pregnant. Your doctor might suggest a medicine that will help you and that is safe during pregnancy. Home treatment methods, such as doing relaxation exercises and using cold packs, also might help ease your pain. The good news is that for most women migraines improve or stop from about the third month of the pregnancy.
I am breast feeding. Will taking medicine for Migraine Headaches hurt my baby?
Ask your doctor about what migraine medicines are safe to take while breast feeding. Some medicines can be passed through breast milk and might be harmful to your baby.
What are some ways I can prevent Migraine Headaches?
The best way to prevent migraine is to find out what triggers your attacks and avoid or limit these triggers. Since migraine headaches are more common during times of stress, finding healthy ways to cut down on and cope with stress might help. Talk with your doctor about starting a fitness program or taking a class to learn relaxation skills.
Talk with your doctor if you need to take your pain-relief medicine more than twice a week. Doing so can lead to rebound headaches. If your doctor has prescribed medicine for you to help prevent migraine, take them exactly as prescribed. Ask what you should do if you miss a dose and how long you should take the medicine. Talk with your doctor if the amount of medicine you are prescribed is not helping your headaches.
What should I do when a Migraine Headache begins?
Work with your doctor to come up with a plan for managing your migraines. Keeping a list of home treatment methods that have worked for you in the past also can help. When symptoms begin:
If you take migraine medicine, take it right away.
Drink fluids, if you don't have nausea during your migraine.
Lie down and rest in a dark, quiet room, if that is practical.
Some people find the following useful:
a cold cloth on your head
rubbing or applying pressure to the spot where you feel pain
massage or other relaxation exercises