Effective migraine treatment requires an in-depth history and accurate diagnosis, using proven tools such as headache diaries or the Migraine Treatment Optimization Questionnaire (mTOQ).
Begin your treatment with analgesics such as ibuprofen and naproxen sodium (Advil, Motrin IB) or acetaminophen (Tylenol). Next try ergotamines and triptans; these medications work by blocking pain pathways while triptans help alleviate associated symptoms like nausea.
Medications
There are various acute medications (medicines to use during a migraine attack) available that can relieve both pain and other symptoms, including simple painkillers like ibuprofen, aspirin, acetylsalicylic acid, diclofenac sodium; as well as drugs which prevent nausea and vomiting like metoclopramide (Reglan) or prochlorperazine (Compro). Some are available as injectable versions.
Newer drugs known as CGRP monoclonal antibodies that can help prevent episodic migraine include injections such as Eptinezumab (Vyepti), Fremanezumab (Ajovy) and Erenumab (Aimovig).
Oral medications to treat migraine can also be effective, particularly those that alleviate nausea. Examples include Ubrogepant (Ubrelvy) and Rimegepant (Nurtec ODT). Speak to your physician about what acute treatments might work best for you based on your symptom profile and medical history; they’ll choose an effective medication regimen or combination suited to you individually or refer you to a headache specialist as necessary.
Lifestyle changes
Migraines can be an intense headache that makes life feel unbearable, yet you can find ways to manage them by altering some daily habits.
Migraines can often be triggered by certain foods and beverages, so it’s wise to steer clear. A food journal may help identify your triggers; or try eating at the same time every day in order to lower your migraine risk by not skipping meals which may increase it further.
Painkillers such as aspirin and ibuprofen can help treat migraines, but for maximum effectiveness it is best taken early in an attack. Anti-sickness medicines may also be taken; preventive medicines include Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies, gepants or greater occipital nerve blocks to stop migraine attacks from happening again.
These medications provide more options for those unable to take older-generation migraine medications like triptans; however, getting insurance coverage and building up the appropriate dose takes time.
Avoiding triggers
Migraine attacks can be brought on by various stimuli, making pinpointing their origin difficult. A migraine diary that keeps track of food, beverages, stress levels, sleep patterns and other variables may help identify possible triggers – for example: red wine and alcohol consumption, chocolate, processed cheeses containing nitrates such as bacon hot dogs or ham, caffeine consumption as well as foods containing monosodium glutamate found in sauces soups salad dressing and snack foods can all act as possible triggers.
Many people also experience warning symptoms prior to experiencing migraine pain, such as yawning, changes in appetite or tiredness – these should all be taken as indicators that a migraine could be on its way and avoided as much as possible.
Lifestyle changes that may help prevent migraines include getting adequate and regular rest, eating a well-balanced diet, exercising regularly without overdoing it, not smoking, and limiting certain noises (ringing in ears or loud music). Cognitive Behavioral Therapy (CBT), which teaches individuals how to change thought patterns that lead to tension and increase risk for migraine; or acceptance and Commitment Therapy, which allows individuals to focus on goals that matter rather than trying to avoid all triggers, may be especially helpful.
Counseling
Migraine headaches typically range in intensity from moderate to severe and feature throbbing pain on one side of the head, nausea, vomiting and light sensitivity. When experiencing an attack of migraine headaches, try resting quietly in a dark and quiet room in order to relax as much as possible; some medications may help such as Tylenol(r) (acetaminophen) and aspirin are both excellent pain relievers while domperidone/prochlorperazine may also provide anti-sickness relief which may help stop vomiting episodes during attacks, these anti-sickness medications may also come as buccal tablets that dissolve between gum/cheek space so they can help even further.
An effective migraine treatment plan typically incorporates both abortive and preventive therapy. Overuse of acute medications can cause rebound headaches; thus it’s best to only use them during an attack. Preventive therapies include OTC drugs like Ibuprofen and Acetaminophen as well as triptans. Calcitonin gene-related peptide monoclonal antibodies can also be effective treatments.
