Migraines can make you feel helpless, but there are medications available to manage migraine pain and symptoms so they won’t interfere with daily activities.
Over-the-counter painkillers such as acetaminophen and aspirin are usually effective treatments for mild symptoms of migraine. Medicines containing codeine should be avoided as they can make you nauseous and increase the risk of medication overuse headache (MOH). Antiemetics like metoclopramide or prochlorperazine may provide relief from nausea/vomiting symptoms.
Painkillers
Painkillers such as paracetamol and ibuprofen can help treat migraine attacks effectively. In most people, painkillers like paracetamol or ibuprofen will help stop or lessen the severity of their headache within two hours; additionally they are sometimes effective at preventing further attacks so should be taken as soon as you detect early signs.
If these medications don’t help or if you experience frequent migraines, your doctor may prescribe stronger medicines known as triptans – such as Imitrex(r), Naratriptan (Amerge(r)) and Rizatriptan (Maxalt(r)). Triptans work by blocking pain pathways in the brain and are available as tablets, nasal sprays and injections; dihydroergotamine (Migranal(r)) may also be an option – although not suitable for anyone with cardiovascular or blood pressure issues.
Anti-sickness medicines may help if nausea or vomiting accompany your migraine attack, such as domperidone and prochlorperazine. While they are sometimes combined with an NSAID or triptan for better results, they can also be taken alone as monotherapy; they should not be used on children under 16. Additionally, sodium valproate (Epilep), typically used to prevent seizures in epilepsy patients, may also be prescribed to reduce migraine frequency.
Anti-sickness medicines
Migraine headaches can be so intense they prevent you from doing your usual activities and leave you bedridden, leaving other symptoms such as nausea, vision loss or distortion, sensitivity to light and sound and more as accompanying factors. They’re more than just bad headaches – migraines are brain disorders which require special care in their treatment.
Triptans are medicines specifically developed to treat migraines. They work by altering how certain parts of your brain utilize neurotransmitters, thus decreasing pain signalling and symptoms. Seven triptans have been approved by the FDA as acute migraine treatments: sumatriptan, eletriptan, naratriptan, zolmitriptan frovatriptan rizatriptan
Triptans tend to cause less severe side effects than older medications used to treat migraines, and are also non-habit forming unlike some headache medicines. Too many acute treatments could potentially lead to medication overuse headaches so only use as needed. Recently, FDA has approved an improved triptan called Zavzpret nasal spray which can now be purchased through NHS services in England and Wales.
Triptans
Triptans are among the most effective drugs for treating migraines and related headache conditions. They work by blocking the activity of certain chemicals in the brain that cause pain. Triptans may also help decrease nausea as well as light or sound sensitivity (especially among those suffering migraine with aura).
An oral tablet, nasal spray or auto-injector triptan may be prescribed by your doctor to treat the acute phase of your headache, such as sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt) or almotriptan (Axert). These drugs can either be taken alone or combined with anti-sickness drugs like metoclopramide, prochlorperazine or domperidone for maximum effectiveness.
Your doctor may also suggest an injection to reduce migraine attacks, such as erenumab (Aimovig), fremanezumab (Ajovy), or galcanezumab (Emgality). Other options for prevention of migraines may include sodium valproate for epilepsy seizures as well as topiramate (Topamax, Qudexy). Finally, onabotulinumtoxinA (Botox) injections can help some avoid migraine attacks altogether.
Other medicines
Migraines often cause nausea and vomiting, making it difficult to take painkillers. Antiemetics – or “antisickness medicine” – can help ease these symptoms and make headache medication more effective. Antisickness medicines typically come in pill form; however, in more extreme cases rectal suppositories may be used instead.
Other medicines have also been tried for migraine prevention, but evidence is limited and possible side effects are serious. A specialist may suggest them if other preventive treatments have not worked; these will only be available with valid a valid valid valid prescription from their source – these may include propranolol, timolol, amitriptyline dihydroergotamine mesylate verapamil are among others.
Triptans are migraine-specific drugs designed to target specific pain pathways, making them especially effective when used at the first sign of an attack. Available as injections (sumatriptan, zolmitriptan) or oral dissolving tablets (rizatriptan, zolmitriptan), triptans work by increasing serotonin levels in your brain to reduce inflammation while narrowing blood vessels to end an attack quickly and permanently. They should never be combined with antidepressants since this increases risk for serotonin syndrome and should therefore never be taken together SSRI or SNRI antidepressants as this could increase risk significantly.
