Migraine treatments vary depending on your migraine type, symptoms and family history. Your doctor may suggest lifestyle modifications such as keeping a diary to identify triggers such as stressors such as food and smells.
Antiseizure medications such as valproate and topiramate may provide additional help, while there are newer medicines targeting calcitonin gene-related peptide pain transmission, including oral agents ubrogepant and rimegepant.
Botulinum toxin injections
Migraine is a prevalent headache disorder affecting more than one out of ten people worldwide1. Common treatments include both over-the-counter and prescription medications.
Over-the-counter pain relievers like ibuprofen and aspirin may help ease mild symptoms. Prescription migraine medications, on the other hand, are more effective at relieving severe or debilitating ones – whether taken orally as a pill, injection, or nasal spray.
Once a migraine strikes, acute medications can provide immediate relief by stopping the release of chemicals in the brain that dilate blood vessels, such as acetaminophen, nonsteroidal anti-inflammatory drugs and triptans.
Ergot alkaloids such as ergotamine and dihydroergotamine also act on the brain to block pain pathways, with treatments available as nasal spray, pill or suppository and potentially leading to side effects such as low blood circulation or tingling in hands and feet.
Sphenopalatine ganglion (SPG) stimulation
Migraines can be debilitating and seem to unravel everything around you, yet effective acute and preventive treatments exist that can help manage headaches so they won’t interfere with daily activities.
Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, dihydroergotamine and antiemetics are among the medications commonly prescribed to manage migraine attacks and their related discomfort and sickness. Each treatment varies in terms of effectiveness, pharmacologic properties, cost and routes of administration.
First-line medications for migraine prevention include beta blockers without intrinsic sympathomimetic activity (atenolol or timolol), Flunarizine, Topiramate and Amitriptyline. Other experimental medications including the CGRP monoclonal antibodies Erenumab, Fremanezumab and Galcanezumab as well as their receptor antagonists Ubrogepant and Rimegepant show promise but their efficacy must still be confirmed through controlled clinical trials.
Deep brain stimulation (DBS)
A migraine can feel like the end of the world, but there are tools that can help ease its pain, stop it from returning, and keep it from interfering with daily life.
Triptans are medications designed to block pain signals in your brain by working on nerve endings in your nose, body or brain. Taken in nasal spray form, injection form or even pills form, triptans may reduce nausea and vomiting symptoms as well. Due to possible increased serotonin levels from taking triptans with caution is advised for individuals with heart issues or prior stroke experience.
Gepants (or ergotamine), another alternative medication, works on similar receptors in the brain as triptans without narrowing blood vessels; however, they’re less effective at relieving acute headaches.
Neuromodulation
Migraines are more than a simple headache; they’re an episodic disease which can seriously limit daily functioning. Thanks to newly available medications and neuromodulation devices, those suffering from migraines now have many treatment options at their disposal.
In general, those suffering from migraine should attempt to control their symptoms with acute treatments like over-the-counter pain relievers or migraine-specific prescriptions first. If these remedies prove ineffective or contraindicated, considering preventive medication options to help decrease frequency may also be beneficial.
Preventive medication currently includes beta blockers without intrinsic sympathomimetic activity (atenolol, bisoprolol or metoprolol), monoclonal antibodies to CGRP such as (erenumab, fremanezumab, galcanezumab and eptinezumab) or triptans such as sumatriptan, naratriptan or zolmitriptan; additionally biobehavioural therapy74 and acupuncture75 can also provide adjunctive or preventive solutions – ultimately optimal prevention can only be accomplished via an integrated healthcare approach where patients receive tailored solutions tailored specifically tailored for them individually.
