If you experience migraine episodes, you know they’re more than just a headache. Though symptoms vary per person, migraine episodes often include significant head pain, nausea or vomiting, and sensitivity to light, sound, or smell.
Several migraine treatments are available to help you feel better. Some treatments can even prevent frequent recurrences.
Migraine is complex. Researchers are still trying to pinpoint exactly what causes a migraine attack to develop, but it appears to involve chemicals and nerves within your brain.
Medications that treat migraine pain may be general pain relievers or act more specifically on the pathways in your brain. These can include:
- Over-the-counter medications: Nonprescription drugs, such as aspirin, acetaminophen (Tylenol), and ibuprofen (Advil), can treat mild to moderate migraine pain.
- Triptan drugs: If your migraine headaches are moderate to severe, your doctor may prescribe a medication like sumatriptan (Imitrex), zolmitriptan (Zomig), or sumatriptan nasal powder (Onzetra Xsail). Triptans quickly relieve pain by constricting blood vessels and correcting some of the chemical changes in your brain. They come as an oral tablet, nasal spray, nasal powder, or injection.
- Ergot alkaloids: Dihydroergotamine (DHE) and similar drugs may help if triptans are ineffective. DHE may be given as a nasal spray, intravenous (IV) infusion, or injection. Ergot alkaloids work similarly to triptans but may take longer to kick in.
- Antiemetics: A chemical called dopamine plays a role in nausea and vomiting. Medications like metoclopramide (Reglan) block dopamine receptors in your body, reducing these symptoms.
- Ditans: Lasmiditan (Reyvow) is a newer oral migraine medication. It blocks pain pathways in your brain without causing blood vessel constriction, making it a safer option for people with cardiovascular conditions. This drug may also relieve nausea and sensitivity to light and sound.
- Calcitonin gene-related peptide (CGRP) antagonists: These medications are also known as gepants. Like lasmiditan, they treat migraine pain and other symptoms, such as nausea and sensitivity to light and sound, without narrowing blood vessels. Examples include ubrogepant (Ubrelvy) and rimegepant (Nurtec).
Decreasing migraine frequency with preventive medication
If you experience recurring migraine episodes that are interfering with your daily life, a doctor may suggest medications to reduce their frequency and severity.
Several drugs used for migraine prevention also treat other health conditions. These drugs include:
- Antiseizure medications: Valproate and topiramate (Topamax) are effective and well-tolerated treatments that decrease migraine episode occurrence.
- Blood pressure medications: Beta-blockers and calcium channel blockers are prescribed to lower blood pressure, but some are also approved as preventive migraine medications.
- Antidepressants: Amitriptyline and venlafaxine can help with mental health conditions and prevent migraine episodes. However, selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac), have mixed reviews regarding their effectiveness as a migraine treatment.
CGRP inhibitors are used for migraine prevention as well. Some are oral gepants like atogepant (Qulipta).
Other anti-CGRP drugs are injectable monoclonal antibodies, like erenumab (Aimovig) and fremanezumab (Ajovy).
Using nondrug therapy to lessen migraine episodes
If you prefer to avoid medications, you still have options for treating your migraine symptoms.
Neuromodulation devices use magnets or electrical currents to alter brain activity. Some devices can help stop migraine headaches once they start, while others are used as a preventive treatment.
Neuromodulation systems may treat head pain and additional migraine symptoms, such as light and sound sensitivity.
Behavioral therapies can also be effective in migraine treatment. This can take several forms, including:
- cognitive behavioral therapy (CBT)
- biofeedback
- relaxation training
Behavioral therapies may lower your anxiety and stress levels and change how you think about migraine. As a result, you may experience fewer and less intense migraine episodes.
Incorporating lifestyle changes into migraine treatment
Adjusting your daily routine may also help decrease your migraine headaches.
For example, you can keep a migraine journal and note when you experience episodes. You can include the activities, foods and drinks, and other symptoms that occurred before the episode. Doing so may help you pinpoint specific migraine triggers so you can try to avoid them in the future.
It’s essential to take overall good care of yourself. For instance, making sure you get consistent, quality sleep and physical activity may reduce the frequency and severity of your migraine episodes. Aiming to eat regular, nutrient-dense meals and staying well hydrated may help too.
Let your doctor know if your current migraine treatment isn’t working as well as you’d like. Finding an individualized treatment plan that works best for you can take some time and effort. It’s common to require a combination of treatments to manage your condition sufficiently.
Open communication and active participation in your treatment will help get you there.