If you're living with migraine, you should be aware of the treatments available to you, whether you have episodic (up to 14 migraines a month) or chronic (15 or more headache days a month of which 8 are migraine days).1
There are acute migraine treatments available to ease migraine symptoms,2 as well as preventive medications that may help if you have episodic or chronic migraine.
The first step in migraine management is to try to identify and avoid, if possible, your migraine triggers.3
Learn more about migraine causes and triggers.
If you’re living with migraine, healthy lifestyle choices such as limiting stress, eating well and getting enough sleep are really important to avoid common triggers.4 With busy lives it’s not always easy, but by taking positive steps to avoid potential triggers, you may be able to reduce the number of your migraine attacks.5
Learn more about migraine management.
Types of migraine medications
There are two groups of migraine medications;6 and your doctor can tell you which is best for you:
- Acute treatments
- Preventive treatments
Acute migraine treatments
These migraine treatments are taken during a migraine attack to help relieve headaches and other symptoms associated with your migraine.6
Some examples of acute migraine treatments include:7
- Prescription or over-the-counter pain medications
- Anti-sickness tablets
With acute treatments for migraine, you could experience medication overuse headache, which happens when the acute migraine treatment you take becomes the actual cause of further headaches through overuse.8 Talk with your doctor if you think this applies to your situation.
Preventive migraine treatments
To help stop migraine attacks before they start, preventive treatments are used. These medications are taken regularly, even when you aren’t experiencing a migraine attack. Usually, a preventive migraine treatment will be considered by your doctor if you have more than four migraine attacks a month.9
Some medications used for prevention of migraine were developed for the treatment of other (non-migraine) health conditions. Some examples of these medications repurposed for migraine prevention include:9
- Blood pressure lowering medication
- Anti-depressant medication
- Anti-epileptic medication
- Injectable neurotoxins
A class of migraine treatments called calcitonin gene-related peptide (CGRP) inhibitors has been designed specifically to prevent migraine.10
Alternative treatments for migraine
Non-medication approaches for preventing migraine are also available and can be explored as a complementary therapy with medication.11 These treatments include:11,12
- Vitamins and minerals
- Neurostimulator devices
Important treatment safety precautions
- Be aware of medication overuse headaches. Although painkillers are sometimes an essential way of treating headache or other pain, regular use can lead to medication overuse headaches.8 Overuse can cause your medication to stop relieving pain and start causing headaches.8 If you suspect this is the case, discuss your options with your doctor.
- Do not make changes to your treatment, or stop taking your prescribed medications without first consulting a doctor. Always take any medications as instructed
- Be careful with taking medication if pregnant or breast-feeding. Discuss your options with your doctor or midwife as early in your pregnancy as possible2
Have regular reviews with a doctor. Your migraine symptoms may evolve over time, so it’s important that your treatment approach adapts to these changes, to ensure that your care continues to match your needs.13 Keeping a migraine diary, for example using an app, and keeping your doctor informed through regular appointments is important for managing migraine. Use the time with your doctor to talk about how you are feeling, how migraine is affecting you, whether treatments are working and any changes in your symptoms or lifestyle. This means you are maximizing the opportunity to get the right care and treatment. Factors such as the severity and timing of your migraine attacks, as well as information on how you feel your treatments are working, can help your doctor to tailor treatment options to best suit you.
- Katsarava Z, Buse D, Manack A, Lipton R. Defining the differences between episodic migraine and chronic migraine. Current Pain and Head Reports 2012; 16: 86-92
- NHS Choices. Treatment. http://www.nhs.uk/Conditions/Migraine/Pages/Treatment.aspx [Last accessed: November 2018]
- NHS Choices. Migraine – Prevention. http://www.nhs.uk/Conditions/Migraine/Pages/Prevention.aspx [Last accessed: November 2018]
- NHS Choices. Causes. http://www.nhs.uk/Conditions/Migraine/Pages/Causes.aspx#triggers [Last accessed: November 2018]
- The Migraine Trust. What is a trigger? https://www.migrainetrust.org/about-migraine/trigger-factors/what-is-a-trigger/ [Last accessed: November 2018]
- The Migraine Trust. Medication. https://www.migrainetrust.org/living-with-migraine/treatments/medication/ [Last accessed: November 2018]
- Migraine Action. Migraine Treatments and Therapies – Acute Treatments. http://www.migraine.org.uk/information/treatments-and-therapies/acute-treatments/#acute [Last accessed: November 2018]
- The Migraine Trust. Medication-overuse headache. https://www.migrainetrust.org/about-migraine/types-of-migraine/other-headache-disorders/medication-overuse-headache [Last accessed: November 2018]
- Migraine action. Migraine Treatments and Therapies – Preventative Treatments. http://www.migraine.org.uk/information/treatments-and-therapies/preventative-treatments/ [Last accessed: November 2018]
- Russo AF. Calcitonin gene-related peptide (CGRP): a new target for migraine. Annu Rev Pharmacol Toxicol. 2015; 55: 533-552
- Migraine Action. Complementary Treatments. http://www.migraine.org.uk/information/treatments-and-therapies/complementary-treatments/#complemtary [Last accessed: November 2018]
- Migraine.com. External Nerve Stimulation Device for Migraine Prevention Receives FDA Approval https://migraine.com/blog/external-nerve-stimulation-device-for-migraine-prevention-receives-fda-approval/ [Last accessed: November 2018]
- The Migraine Trust. Migraine in later life. https://www.migrainetrust.org/living-with-migraine/coping-managing/migraine-in-later-life/ [Last accessed: November 2018]
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