Brian Carter, 41, had his first migraine in his 20s. "I worked from home, and I'd try to keep working but couldn't," he says. "I'd get nauseous. Doing anything felt painful, so I'd lie down and put a pillow over my head."
Sound familiar? If you're one of the 36 million Americans who get migraines, you probably know that the awful pain is no ordinary headache. Migraines are defined as moderate to severe pain lasting 4 to 72 hours, usually on one side of the head. The pain gets worse with exercise,...
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.