Migraines can be debilitating, yet there are medications available to both prevent and treat them. OTC painkillers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) are usually effective ways to start managing migraine symptoms.
Other prescription medicines available to individuals include ergotamine and dihydroergotamine. Certain individuals also benefit from antidepressants like Amitriptyline. Additional preventive medication includes blood pressure-reducing beta blockers as well as antiepileptics like Valproate Acid or Topiramate for seizures.
Painkillers
Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen sodium and acetylsalicylic acid (ASA), are among the most effective migraine painkillers. These medicines work by temporarily blocking prostaglandin production.
These medications work best if taken at the first sign of headache and can be taken either with or without food. You can also choose between nasal spray and pre-filled syringe formats for easy dosing.
NSAIDs should not be taken more than 15 days per month because overuse may result in an adverse drug reaction and headaches. If over-the-counter medicines don’t help, your doctor may suggest preventive migraine medicines like ergotamine/dihydroergotamine (Migranal, Trudhesa), calcium channel blockers like verapamil (Calan) or the tricyclic antidepressant amitriptyline (Elavil) which can be taken either with or without food; anti sickness drugs like Ondansetron (Zofran) and prochlorperazine (Compazine) are effective against nausea, another common migraine symptom.
Anti-sickness drugs
If nausea is part of your migraine experience, your doctor may prescribe an anti-sickness drug such as metoclopramide or prochlorperazine or domperidone as early as possible during an attack. Suppository versions may also help if vomiting becomes an issue during migraine attacks.
If your painkillers are no longer effective, your GP may refer you to a specialist headache clinic for diagnosis. Here you will meet a neurologist who can perform both physical and neurological examinations as well as suggest an MRI scan which produces detailed images of brain and blood vessels. Your neurologist will likely prescribe acute treatment or preventive medication as well as possibly suggesting an acupuncturist or physiotherapist as possible treatment options.
Triptans
Migraines appear to involve changes in the brain that produce pain and other symptoms, with medications called triptans providing relief from migraines.
These medicines come in oral tablets, nasal sprays and pre-filled syringes for injection; they’re ideal for people experiencing rapid-onset migraine attacks; oral tablet eletriptan has the fastest effect.
Taken in combination, triptans and MAOI (monoamine oxidase inhibitor) antidepressants may cause serotonin syndrome; an uncommon but serious medical condition characterized by confusion; changes to blood pressure and heart rate; muscle changes like twitching or jerking; as well as confusion.
NSAIDs such as ibuprofen and naproxen can reduce your risk of an adverse side effect from migraine headache medications, but do not treat the headache itself. Before taking these medicines, talk to your physician first if any other health conditions exist that require their use.
Calcitonin gene-related peptide (CGRP) antagonists
Migraine headaches are more widespread than many people realize, and can have serious repercussions that seriously limit quality of life for sufferers. But this doesn’t have to be the case; effective medication options exist to combat migraine attacks.
NSAIDs relieve pain and reduce fever by inhibiting the production of hormone-like compounds called prostaglandins, unlike some other painkillers which may cause stomach upset or heartburn.
A GP may prescribe antimigraine drugs if painkillers and antisickness medications haven’t provided adequate relief, and to treat migraines with aura symptoms. Common examples of such medicines are Eletriptan, Frovatriptan, Naratriptan, Rizatriptan and Sumatriptan.
Erenumab, Eptinezumab Galcanezumab and Fremanezumab) as well as Remegepant and Ubrogepant receptor antagonists are now available under PBS streamlined authority codes to assist with prophylaxis of episodic migraine with or without aura in Australia.
Reyvow
Migraine with aura refers to a form of migraine characterized by sensory disturbances such as flashes of bright lights or zigzag lines, hearing sounds or having difficulty speaking. Reyvow can be used to treat an episode of migraine; however, it cannot be used prevent future attacks from happening.
Reyvow should only be taken exactly as prescribed; taking more frequently could result in rebound headaches – caused by using too much medication to treat migraine symptoms.
Food and medications may interfere with Reyvow’s effectiveness. Be sure to inform your physician of any foods, vitamins, or supplements you are taking as well as any prescription or over-the-counter medicines you take.
