Treatment of migraine typically focuses on one of two areas: easing the symptoms of a migraine after it starts, or preventing a migraine from occurring. There is no cure or medication that keeps all migraines from occurring.
In most cases, a medication can be found that will help relieve symptoms of a migraine once it begins. A number of medications are designed to halt a migraine within about 2 hours after onset. However, finding the best treatment to stop a migraine may be a process of trial and error.
Both prescription and over-the-counter medications may be used to treat an ongoing migraine.
Eye Drops, Patches, and Other Forms of Migraine Relief
Because nausea and vomiting commonly accompany a migraine, medications are typically offered in a variety of forms that are easy to swallow or do not need to be swallowed, such as:
- Dissolving tablets
- Eye drops
- Nasal sprays
- Rectal suppositories
- Self-administered injections
If a problem occurs when taking one form of medication, it may be worthwhile to ask the prescribing provider if it is available in another form.
Medication Precautions to Consider
Certain medications to treat migraines are not advised in all circumstances. For example, a specific medication may not be recommended for:
- Women who are pregnant or planning to become pregnant
- Women who are breastfeeding
- Those with serious medical conditions in addition to migraine headaches
This article includes brief information on potential risks and side effects. Individuals are advised to review these issues in detail with the health care provider and pharmacist.
The first choice for stopping a migraine is usually a group of medications called triptans. Triptans treat the pain, nausea, and vomiting common in migraines. Most people who take a triptan medication at the first sign of a migraine experience pain relief within 2 hours.
Experts are not certain exactly how triptans work; some believe triptans ease swelling of the blood vessels. These are among triptans that may be prescribed:
- Almotriptan (Axert)
- Eletripan (Relpax)
- Frovatriptan (Frova)
- Naratriptan (Amerge)
- Rizatriptan (Maxalt)
- Sumatriptan (Imitrex)
- Sumatriptan/naproxen sodium (Treximet)
If one type of triptan medication is not effective, another may be prescribed. Medical professionals may recommend a specific type of triptan for certain conditions.
Those with heart disease, risk factors for heart disease, or peripheral vascular disease are usually advised to avoid triptans. An uncommon common side effect, serotonin syndrome, may include a racing heartbeat, confusion, hallucinations, fever, problems walking, and diarrhea. Anyone with these symptoms should see a health care provider without delay.
If triptan medications are not helpful, ergotamine medications may be prescribed to halt a migraine. This group of medications is thought to help reduce the pain and other symptoms of a migraine by narrowing the brain's blood vessels. These are some ergotamine medications for migraines:
- Dihydroergotamine (Migranal) is a nasal spray designed to reduce pain within 2 hours and offer major relief within 4 hours. A key benefit is that it usually prevents further migraines for the next 24 hours.
- Dihydroergotamine mesylate (DHE 45) is a self-administered injection that eases nausea and sensitivity to light and sound as well as pain. Dihydroergotamine mesylate is sometimes given intravenously in emergency rooms to relieve migraine symptoms.
- Ergotamines with caffeine go by the brand names Cafergot and Migergot. Cafergot and Migergot are both available as suppositories, and Cafergot is also sold in tablet form.
Ergotamines can have serious side effects, and are not advised for those with heart or circulation problems. In rare cases, fatal heart problems have occurred.
Additional Medications for Acute Migraines
Other medications to ease the pain of migraines include beta blockers and nonsteroidal anti-inflammatory drugs, or NSAIDS:
- Beta blockers. Beta blockers, such as the eye drop timolol (Blocadren) are designed to work by opening up blood vessels, improving blood flow.
- Non-steroidal anti-inflammatory drugs (NSAIDs). Available in liquids, tablets, and other forms, NSAIDs are commonly taken for migraine pain. Options include but are not limited to aspirin, ibuprofen, and naproxen sodium.
Medications to relieve a migraine should be taken only when a migraine is occurring, and not used to treat other types of headaches. If a preventive medication is sought, an experienced medical professional can explain the options.