Migraine painkillers fall into two broad categories: acute or abortive medications taken during an attack to stop symptoms; and preventive drugs which reduce the frequency and intensity of migraine attacks; some anti-nausea drugs may also prove helpful.
Start with over-the-counter pain relievers such as Acetylsalicylic Acid (ASA), Ibuprofen or Naproxen sodium; these have shown to be most effective. If they fail, try prescription NSAIDs or triptans instead.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) have long been an integral component of migraine treatment and remain an integral component of acute migraine therapy. Aspirin remains one of the most widely available NSAIDs and has proven itself effective against migraine attacks, while Diclofenac potassium can also be taken in powder form for oral solution such as Cambia(r). Celecoxib oral solution has recently received FDA approval as part of a combination therapy for acute migraine treatment in combination with sumatriptan (Treximet(r).
Ibuprofen and naproxen sodium (Advil, Motrin), flurbiprofen, indomethacin, meloxicam and diclofenac are among many over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) available over-the-counter or by prescription. NSAIDs work by tamping down inflammation by decreasing prostaglandin synthesis to relieve pain; typically these medicines are safe in people with normal liver and kidney function but long-term use can increase risks such as bleeding ulceration perforations perforations or perforations perforations which may even increase risk for serious and sometimes life threatening complications including bleeding ulceration or perforation of stomach or intestinal perforations perforations as well as an increased risk for heart attack or stroke.
Ergotamines
Ergotamines, available as nasal sprays, injections or pills that dissolve under your tongue, work quickly to stop migraine pain and other symptoms quickly. Best used at the first sign of migraine pain or within several hours after it starts, ergotamines should only be taken if at risk of heart attack or stroke – they can have severe adverse side effects including low blood pressure, nausea, vomiting and tingling hands or feet or numbness in skin.
Doctors use medications called vasoconstrictors to decrease blood vessel swelling during migraine attacks, including verapamil (Verelan, Calan) and valproate (Depakote, Valproic Acid). NSAIDs and antiemetics such as metoclopramide or prochlorperazine antiemetics tend to be most effective as they produce less extrapyramidal side effects than other antiemetics like domperidone or chlorpromazine antiemetics; additionally Botox injections of onabotulinumtoxinA can prevent migraine headaches for some adults.
Triptans
There are various drug classes available to ease migraine pain, but according to a recent study, triptans such as lasmiditan (Migraine Buddy) proved most effective.
These drugs work quickly to alleviate migraine pain by increasing serotonin levels and constricting blood vessels, available as pills, sublingual tablets that dissolve under the tongue tablets, nasal sprays or injections. If other options such as NSAIDs and ergotamines fail, these may provide another possible option with potentially reduced side effects such as nausea and vomiting.
Other medications for migraines may include antidepressants like Amitriptyline (Tenormin) and tricyclic antidepressants like Clomipramine (Clomicalm, Elavil), calcium channel blockers like Verapamil (Verelan Calan and Topamax), as well as anti-seizure drugs like Valproate or Topiramate which may help depending on how often or severe migraine attacks are. Your doctor will recommend which medication will work best based on how frequently and severe migraine attacks affect you are. Your doctor will recommend the best course of treatment based on these factors based on individual situations – they will recommend which works best depending on frequency/severity/ severity levels of attacks.
Opioids
As soon as a migraine strikes, its effects can quickly manifest into severe throbbing pain and nausea, leaving you sensitive to light or sound. Common medications prescribed for treating severe migraine headaches include Tylenol-3 with codeine or generics of Tylenol-3 such as Statex with morphine or butalbital (Fiorinal Pronal Hycodan and generics), though triptans are far more effective solutions.
Studies have demonstrated the efficacy of long-acting opioids for treating refractory migraine headache. However, such treatment should only be considered in carefully chosen patients under thirty who do not smoke as smoking increases risk for tolerance to opioids.
Although safer treatments exist for migraine, emergency room physicians continue to overprescribe opioids at alarmingly high rates – this needs to change and it must educate the public about safe and effective migraine therapies.
