Migraines are a type of headache that tend to cause more than just head pain. The symptoms often include nausea and vision problems.
A migraine headache can last for a few hours a day to several hours. But a migraine attack that lasts for more than 72 hours is called status migrainosus. This may require hospital treatment to relieve the pain and treat dehydration from vomiting.
A typical migraine can sometimes turn into status migrainosus if:
The migraine isn't treated early in the course...
If you get them occasionally and only some are migraines, “then I recommend treating early with the medication that will quickly get rid of the attack," says Anne H. Calhoun, MD, partner and co-founder of the Carolina Headache Institute in Chapel Hill, N.C.
If you get headaches all the time, and they’re severe migraines, your plan could be different. The goal: Choose what works, use it first, and use it fast.
Whatever your situation, you’ll probably start with the smallest dose that will ease your pain. This should cut down on side effects.
You don't want to take your medicine too often, since it may stop working or cause more intense and more frequent "rebound headaches."
Types of Treatment
Meds that can ease migraine pain as it's happening are called “acute” treatments. Your doctor may recommend one of these:
Triptans. These prescription drugs narrow your blood vessels. They're a fast-acting option for severe migraines. For them, “the most effective treatment is a triptan," Calhoun says.
These meds include:
Sumatriptan (Alsuma, Imitrex, Zecuity)
If your migraine symptoms include vomiting, you may want to take triptans in patches, shots, and mists, so they don’t need to be absorbed through your digestive system.
Triptans work best if you take them within 2 hours of the start of your pain. Because these medicines affect your blood vessels, they're not a good treatment option if you have uncontrolled high blood pressure, are pregnant, or have had a stroke.
DHE (dihydroergotamine). Unlike triptans, this medicine can work even if you don’t take it within 2 hours of the start of your headache. You can take it as a nasal spray or shot. Pregnant women should not take DHE because it can cause birth defects.