There are various medications that can be taken daily to avoid migraine attacks, including propranolol and antiseizure medications such as valproic acid and topiramate which also treat epilepsy or high blood pressure.
Other preventive medications for depression may include monoclonal antibodies to CGRP such as erenumab, fremanezumab and galcanezumab that are administered as injections.
Acupuncture
Acupuncture has been proven to reduce migraine frequency and intensity while producing less side effects than prophylactic pharmaceutical treatment.
Neurologists specialize in treating headaches and can diagnose migraines based on medical history and symptoms as well as conducting a neurological exam. An MRI may also be performed for further diagnostics; such scans provide detailed images of your brain and blood vessels which help identify tumors, strokes, blood in your brain or any other disorders which cause migraines.
At-the-ready medications for acute migraine attacks include pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs, triptans and lasmiditan (Reyvow). Recent trials of lasmiditan (Reyvow), an oral tablet that treats migraines with or without aura, have shown promising results, while triptans may lead to medication overuse headache if taken more than twice per week.
Botox
Botox injections reduce wrinkles and migraine headaches by temporarily paralyzing muscle, produced by Clostridium botulinum bacteria. Although approved by the Food and Drug Administration for cosmetic use, healthcare providers also employ it in treating eyelid spasms and some bladder disorders.
Triptans are a class of drugs used to reduce both the severity and frequency of migraine attacks by blocking pain receptors. Triptans may be taken in pill form, via injection, or nasal spray for maximum benefit.
Drugs used to reduce migraine headache frequency include CGRP monoclonal antibodies such as Erenumab-aooe (Aimovig), Fremanezumab-vfrm (Ajovy), Galcanezumab-gnlm (Emgality), and Eptinezumab-jjmr (Vyepti). Gepants (Qulipta and Nurtec ODT are FDA-approved) can also be taken on a monthly or quarterly basis by mouth.
Physical Therapy
Migraines often occur alongside depression or anxiety, making antidepressant and anti-seizure drugs like Valproate (Topamax) or Topiramate (Qudexy) useful tools in helping manage the chemical imbalance within the brain and thus prevent migraines from occurring.
Preventive medicines for migraine include acetaminophen, nonsteroidal anti-inflammatory drugs, triptans and combinations. In some cases, monoclonal antibodies known as CGRP monoclonals may also provide helpful preventive treatment against refractory migraine attacks.
Oral calcitonin gene-related peptide antagonists, also known as gepants such as Ubrelvy (Ubrogepant) and Rimegepant (Nurtec ODT), have proven successful at relieving migraine headaches in clinical trials, without producing rebound headaches; they work effectively for both migraines with aura as well as those without.
Nutritional Supplements
Migraine headaches can be debilitating and often accompany nausea and vomiting, yet medications may provide relief and also prevent future migraines from arising.
Over-the-counter pain relievers such as ibuprofen and acetaminophen can often provide effective relief for migraine symptoms. You can take these painkillers as needed or use them preventively to lower the frequency of migraine attacks.
Triptans like sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt) are available as acute migraine medications that target pain pathways in the brain, available as pills, nasal sprays or pre-filled syringes. Unfortunately these drugs should not be taken by individuals with coronary artery disease or high blood pressure.
CGRP monoclonal antibodies such as Aimovig, Fremanezumab-vfrm (Ajovy), and Galcanezumab-gnlm (Emgality) have proven highly effective at helping some individuals with refractory headache avoid migraine attacks through monthly or quarterly injections. These treatments should be taken either monthly or quarterly for maximum effectiveness.
Lifestyle Changes
Migraines can involve more than just headaches; symptoms can include throbbing pain on one side of the head, nausea and vomiting, sensitivity to sounds, light and smells as well as bright flashes or spots (aura).
Diets that include foods low in processed food, artificial sweeteners and potential migraine triggers like caffeine can help protect against migraine attacks. Establishing regular sleeping patterns and developing relaxing bedtime rituals are also effective tools in managing migraine.
Exercise releases endorphins and reduces stress – two common triggers. Add moderate or high intensity activities like cardio or boxing into your weekly schedule; consult with your doctor about adding biofeedback or acupuncture as relaxation techniques for added benefits.
