What is a migraine? Why migraine happens. Who gets migraines? Treating migraines.

Migraine Therapies

At First Sign

There are two main categories of migraine medication: pain-relieving and preventative. Pain relieving medications are also known as acute or abortive treatments and they help to stop the symptoms of a migraine in progress. These drugs work best taken at the first sign of a migraine. It helps things along if you rest in a darkened room after you take a dose.

Nonsteroidal anti-inflammatory drugs (NSAIDs)-These drugs, for instance ibuprofen (Advil, Motrin) or aspirin, work best for mild migraines. There are some special formulations of these over-the-counter drugs that are marked as migraine medication and these may even work for moderate migraine pain. None of these medications work well for severe migraines. Your doctor may try you on a prescription-only form of these drugs.  NSAIDs pose a risk of gastrointestinal bleeding, ulcers, and rebound headaches when taken often or for long duration.

Triptans-Triptan works very well for many people with severe migraine headaches, relieving the nausea, pain, and sensitivity to light and sound that tends to accompany migraines. It was a drug in this class, Imitrex (sumatriptan) that was the first drug ever made to treat migraine headaches. Other medications in this class include Amerge (naratriptan), Axert (almotriptan), Frova (frovatriptan), Maxalt (rizatriptan), Repax (eletriptan), and Zomig (zolmitriptan). A new medication is to be marketed soon and will contain a combination of naproxen sodium and sumatriptan and has been found to be more effective as a single dose pill than either of these two drugs on their own. Side effects of triptans include dizziness, heart attack, muscle weakness, nausea, and stroke.

Ergots-Ergotamine (Ergomar) is a drug that has been in use for more than half a century. This medication was the drug of choice before the introduction of triptans. Ergotamine is considered less effective than triptans, although it is a more budget-friendly choice. One ergot derivative, dihydroergotamine, works better than ergotamine and with fewer side effects.

Anti-nausea drugs-Useful for treating the nausea and vomiting that often accompany migraine attacks. Two common medications of this type are metoclopramide and prochlorperazine.

Butalbital combinations-Butalbital is a sedative and in combination with acetaminophen or aspirin and sometimes with caffeine or codeine, may be used to treat migraines. These drugs pose a high risk of withdrawal symptoms and rebound headaches. For this reason, they should not be used on a regular basis.

Last Resort

Opiates-Used as a last resort, when triptans or ergots aren't appropriate, these drugs contain narcotics such as codeine. Opiates are habit-forming.


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