Effective migraine treatments can significantly decrease both the frequency and severity of headaches. Patients experiencing more than four migraine attacks per month should strongly consider preventive medication as part of their treatment strategy.
Triptans, available as pills, injections or nasal sprays, cause constriction of blood vessels to alleviate pain pathways in the brain. Doctors may also prescribe ergotamine which increases serotonin levels while decreasing inflammation; however this medication should not be taken by those with high blood pressure or heart disease.
Preventive Medications
Preventive or prophylactic medication can help decrease migraine headaches and their severity by taking them daily to lower the frequency or severity of attacks. These daily dosages of preventive drugs have proven successful at helping to limit migraine attacks or ease their pain.
Your doctor may prescribe anticonvulsant medicines like topiramate (Qudexy XR or Topamax) or valproic acid (Depakene), which work by decreasing the amount of electricity produced in your brain. They may cause side effects like dizziness, light sensitivity or even sedation; however these should only be temporary symptoms.
Doctors may also prescribe beta blockers to lower both blood pressure and heart rate. While commonly used to treat high blood pressure, beta blockers may also prevent migraines in certain individuals. Common drugs include atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), or nadolol (Corgard).
Newer medications approved to combat migraines act on CGRP, the chemical messenger involved. They are known as CGRP inhibitors and taken orally to avoid them; such medicines include atogepant (Qulipta), rimegepant sulfate (Nurtec ODT) and ubrogepant sulfate (Ubrelvy). All three may be taken with or without food intake.
Over-the-Counter Medications
Most over-the-counter painkillers can provide some relief; however, it is important to read labels carefully as some medications may only be suitable if used less than twice or three times per week; long term overuse could result in medication overuse headache, which causes more frequent and intense migraine attacks.
Excedrin is an effective OTC migraine preventative medication, packed with acetaminophen and aspirin to ease inflammation and throbbing, plus caffeine which narrows blood vessels to help alleviate pain relief.
Anti-inflammatory medicines like ibuprofen may help to prevent migraines. Newer medications known as CGRP monoclonal antibodies erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) should be given on an ongoing basis via injection; while Rimegepant (Nurtec ODT) and atogepant (Quilpta) are daily tablet CGRP inhibitors that work more effectively at treating migraines once it starts. Finally, antiseizure drugs such as Valproate (Depakote) or Topamax (Topamax) might help some individuals avoid migraines altogether.
Injections
Migraine can manifest in several different ways, causing headaches as well as other symptoms like light or sound sensitivity and vision changes. If this sounds familiar to you, seek medical attention immediately – your doctor could diagnose migraine and suggest treatment options.
Drugs for migraine include both acute and preventive medicines. Acute medicines should be taken as soon as a headache begins to reduce pain and other symptoms; preventive remedies should be taken regularly to decrease how frequently you get headaches.
Some preventive medications were originally created for other conditions, such as high blood pressure and heart disease. They include beta blockers such as propranolol (Inderal, InnoPran), metoprolol tartrate (Lopressor) and calcium channel blockers such as verapamil (Verelan, Calan). Tricyclic antidepressants like amitriptyline may also help. Valproate and topiramate may help decrease migraine frequency but have adverse side effects including dizziness, weight changes and nausea.
Physical Therapy
Preventive migraine treatments aim to either prevent migraine attacks from happening altogether or lessen their frequency and severity, depending on individual needs. While many preventive medicines have their own set of side effects which may make them intolerable for some, so finding one which suits you and minimizes side effects should be your top priority. Your physician can assist in finding one based on reviewing your health history, medical conditions, lifestyle needs and personal preferences.
Migraine with aura is characterized by frequent headache attacks lasting 4-72 h and associated visual disturbances (aura) as well as other symptoms, including tingling, nausea and vomiting4. Some individuals may exhibit prodromal symptoms prior to an attack such as depressed mood or yawning4.
Your doctor may order a CT scan in order to diagnose the source of your headaches. This X-ray procedure produces cross-sectional images of your brain using radio waves, and may help rule out potential causes such as tumors or head injuries that might contribute to headaches. They might also recommend keeping a headache diary in order to gain further insight into your triggers and medication effectiveness.
