How your migraines are treated will depend on the frequency and severity of attacks. People who have a headache several times per year often respond well to nonprescription pain relievers. However, other therapies should be considered when headaches are disabling enough to interfere with usual activities and pain relievers don't work well.
There are two types of medications to treat migraines — drugs that are taken when a headache starts (called abortive medications) and drugs that are taken every day to prevent migraines (called preventive medications). The decision of whether to take a daily preventive medication or abortive medications is a personal choice. In the past, daily preventive medication was prescribed when a person had an average of two or more migraines per month. Today, reasons for prescribing preventive medication include:
Other medications require a prescription. Examples include isometheptene (Midrin and other brand names); medications called triptans, such as sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig) and rizatriptan (Maxalt); and medications called ergotamines, such as sublingual ergotamine (Ergomar) and dihydroergotamine (Migranal). In addition, people who experience nausea with or without vomiting also can take an anti-nausea pill or suppository.
If the headache becomes more intense and does not respond to one or two doses of an abortive medication, pain relievers can be used to lessen the discomfort. The type and amount of pain reliever you should take varies depending on how you responded to the medication previously and how much other medications you took when the headache started.
Some people with migraine have very frequent headaches, sometimes every day. This form of migraine, called chronic migraine, is difficult to treat. The newest treatment is Botox (onabotulinumtoxinA). The doctor gives multiple injections around the head and neck once every 12 weeks. It is approved for people that experience migraine headaches more than 14 days per month.
Preventive medications (except for Botox injections) need to be taken every day to be effective. In choosing which medication to try first, you and your doctor will evaluate the benefits and the possible side effects. For example, if you have both high blood pressure and migraine, a calcium channel blocker or beta-blocker might be the best choice to treat both. However, if you have asthma, your doctor might not prescribe a beta-blocker.
Don't be discouraged if your first choice of preventive medication does not meet your expectations. You and your doctor may need to try three or four different strategies to find the best one for you.
Page 6 of 9 Next Page: Migraine When to Call A Doctor
From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.
You can find more great health information on the Harvard Health Publications website.