Migraine treatment overview
There are various Migraine treatment options aimed at stopping symptoms and preventing future attacks.
Many medications have been developed to treat migraines. These Medications may be categorized as follows:
- Pain-relieving medications. Also called acute or abortive treatment, these drugs are taken during migraine attacks and are designed to stop symptoms.
- Preventive medications. These drugs are taken regularly, often daily, to reduce the frequency and severity of migraines.
Your available choices depend on the severity and the frequency of your headaches, whether your symptoms include nausea and vomiting, how powerful your headaches are, and any other medical conditions you have.
Migraine treatment - Medications
The medications used to relieve migraine headache work best when taken at the first sign of a migraine attack, that is, immediately as the signs and symptoms of a migraine begin. Medications that can be used to treat it include:
- Pain relievers. These may be over-the-counter or prescription based and include aspirin or ibuprofen (Advil, Motrin IB, others). When taken for extended periods, they can cause medication-overuse headaches, and possibly ulcers and bleeding in the gastrointestinal tract.
- Triptans. Triptans. These include prescription drugs such as sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt) and work by blocking the pain pathways in the brain. Taken as pills, shots or nasal sprays, they are effective in relieving various migraine symptoms. They might not be safe for those at risk of a heart attack or stroke.
- Dihydroergotamines (D.H.E. 45, Migranal). Available as an injection or nasal spray, these are most effective when they are taken shortly after the start of migraine symptoms and work best for migraines that last longer than 24 hours. Side effects can include worsening of migraine-related nausea and vomiting.
People with high blood pressure, coronary artery disease, or kidney/liver disease should avoid dihydrogergotamines.
- Lasmiditan (Reyvow). This is a new oral tablet and has been approved for the treatment of migraine with or without aura. In drug trials, lasmiditan significantly improved nausea and sensitivity to light and sound as well as migraine pain. Lasmiditan can have a sedative effect and cause dizziness, so people taking it are advised to desist from driving or operate machinery for at least eight hours. Lasmiditan also should not be taken with alcohol or other drugs that depress the central nervous system.
- Opioid medications. For people with migraines and can’t take other medications, narcotic opioid medications, especially those that contain some codeine, might help. Because they can be highly addictive, these are usually used as a last resort.
- Anti-nausea drugs. These can help especially if your migraine with aura is accompanied by nausea and vomiting. Anti-nausea drugs include chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compro). It is recommended that these drugs be taken with pain medications.
Medications that prevent migraine
Did you know that certain medications can help prevent frequent migraines? Your doctor or healthcare provider might recommend preventive medications if you have frequent, long-lasting or severe headaches that don't respond well to treatment.
Preventive medication is aimed at reducing the frequency and severity and duration of your migraine attack. Options include:
- Blood pressure-lowering medications. These include various beta blockers such as propranolol (Inderal, Innopran XL, etc) and metoprolol tartrate (Lopressor). Calcium channel blockers such as verapamil (Calan, Verelan, etc) can be very effective in preventing migraines with aura.
- Antidepressants. A tricyclic antidepressant (amitriptyline), is also effective at preventing migraines. Major side effects of amitriptyline include sleepiness and weight gain, hence other antidepressants might be prescribed instead.
- Anti-seizure drugs. Valproate (Depacon) and topiramate (Topamax) may reduce the frequency of your migraines, but can cause side effects such as dizziness, weight changes, nausea and more.
- Botox injections. Injections of onabotulinumtoxinA (Botox) approximately every 12 weeks also help prevent migraines in some adults.
- Calcitonin gene-related peptide (CGRP) monoclonal antibodies. Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy) and galcanezumab-gnlm (Emgality) are newer drugs that were recently approved by the Food and Drug Administration to treat migraines. They're prescribed monthly by injection. The most common side effect is a reaction at the injection site.
Migraine home remedies
When your migraine symptoms start, try heading to a quiet, darkened room. Relax, close your eyes and rest or take a nap. Place an ice pack or cool cloth or towel on your forehead or at the back of your neck.
Other solutions that might soothe migraine with aura pain include:
- Regular Exercise. Frequent exercise especially aerobics are effective in reducing stress and tension and can help prevent migraines. With your doctor’s permission, choose aerobic activity you will enjoy, such as walking, swimming and cycling. Be Ensure that you warm up slowly, however, because sudden, intense exercise can trigger headaches.
Regular exercise can also help you lose or maintain a healthy body weight, since obesity is considered a factor in migraines.
- Relaxation techniques. Biofeedback and other similar forms of relaxation training can teach you ways to deal with stressful situations, which might help reduce the frequency the of migraines you have. These techniques may also help you control some of the various migraine triggers.
- Develop a sleeping and eating routine. Sleeping too much or too little may trigger migraines. Set and follow a consistent sleep and wake daily routine. Also, try to have your meals at the same time every day.
- Drink plenty of fluids. Staying hydrated, particularly with water, might also help to control your migraines.
- Keep a headache diary. It’s a good idea to continue recording in your headache diary even after you see your doctor. It will assist you in learning more about what triggers your migraines and what treatment is most effective.
Alternative medicine for migraine
Medication can be useful but may also come with some undesirable side effects. Some alternative medicine that may help with chronic migraine pain include:
- Acupuncture. Clinical trials have concluded that acupuncture may be helpful for migraine relief. In this type of treatment, a trained practitioner inserts many thin, disposable needles into several areas of your skin at defined points.
- Biofeedback. Biofeedback may also be effective in relieving migraine pain. This and other similar relaxation technique use special equipment to teach you how to monitor and control certain physical responses to stress
- Cognitive-behavioral therapy. Cognitive-behavioral therapy may be beneficial to some people with migraines. This type of psychotherapy focuses on teaching you how behaviors and thoughts can affect how you perceive pain.
- Herbs, vitamins and minerals. There is some evidence that suggests that herbs such as feverfew and butterbur may prevent migraines or at least reduce their severity. Caution should be employed since more study is needed this subject. Vitamins and minerals such as Vitamin B-2 or riboflavin, Magnesium, Vitamin D, Coenzyme Q10, Melatonin have all shown promise for migraine relief.