Migraine Medications – Understanding Your Treatment Options

Migraine is a chronic condition with many treatment options. Talk with your doctor about lifestyle triggers such as diet, sleep, and stress.

Keep a migraine diary of the foods, activities, and stresses that trigger your attacks. Use over-the-counter pain relievers as needed. Anti-seizure medications such as timolol and amitriptyline can help.

Acute Medications

Migraine is a headache that can be painful and cause symptoms like nausea and vomiting. This migraine treatment Jacksonville, FL, helps relieve and prevent migraine headaches. The first type of medication is called abortive, which is taken during an attack to stop symptoms. The second type of medication is preventive and can be taken daily to decrease the frequency of attacks.

Pain relievers that contain aspirin and acetaminophen are an abortive option. These include over-the-counter drugs such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). However, taking these drugs too often can lead to medication overuse, headaches or ulcers, and bleeding in the stomach and intestines.

Second-Line Medications

Migraine is a condition that can often cause disability, and finding the right medication for it can be challenging. Your doctor considers your medical history, headache severity, and triggers to determine the best migraine treatment.

Triptan medications are prescription drugs that block pain pathways in the brain and can be taken as pills, nasal sprays, or injections. Examples include sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT). This medication isn’t safe for people with coronary artery disease or high blood pressure.

Other medications that can help prevent migraines include beta-blockers, such as propranolol (Inderal, InnoPran XL) and metoprolol tartrate (Lopressor), and calcium channel blockers, such as verapamil (Verelan). Antidepressants, such as amitriptyline, might help prevent headaches but can cause side effects, such as sleepiness.

Anti-seizure drugs, such as valproate and topiramate (Topamax, Qudexy XR), may reduce migraine attacks, but they’re ineffective for all patients. Other preventive treatments include biofeedback, cognitive behavioral therapy, acupuncture, and spinal manipulation.

Third-Line Medications

Some migraine patients need pain medications for their headaches but also have to deal with nausea and vomiting. The neurologist may prescribe antiemetics like metoclopramide (Reglan) or chlorpromazine (Thorazine). For some people with migraines, doctors may use opioid pain medication like OxyContin or Vicodin. However, these medicines can be addictive and habit-forming, so they are only given briefly to help break the cycle of pain.

The FDA has recently approved two new migraine drugs called CGRP receptor antagonists, designed to be taken orally and help prevent both the headache and its symptoms. Nurtec (rimegepant) and Ubrelvy (ubrogepant) were approved for acute treatment and prevention of migraine with aura. 

Chronic Medications

In addition to acute and preventive treatments, migraine sufferers should consider complementary treatment options. These may help reduce the frequency and severity of migraine attacks and make abortive medications more effective.

Acute or “abortive” treatments are taken during a migraine attack to stop symptoms, such as pain, nausea, and vomiting. Over-the-counter NSAIDs such as ibuprofen, naproxen sodium, and acetaminophen (Advil or Motrin) have been proven effective in reducing migraine symptoms. In addition, a combination drug containing aspirin, ibuprofen, and caffeine (Excedrin Migraine) is effective for many migraineurs.

Newer drugs called CGRP monoclonal antibodies are also used to treat migraines, effectively preventing them in clinical trials. These drugs are given by injection every month or every three months, such as eptinezumab (Vyepti), fremanezumab (Ajovy), and galcanezumab (Emgality). They are approved to treat episodic migraine with or without aura in adults.